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General NPI Number Information
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NPI Number | 1104064245
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Entity Type | Organization
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Legal Business Name | AUDWIN B NELSON MD P A
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 10/06/2010
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Provider Practice Location Address
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Address Line | 4215 SUN N LAKE BLVD
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City | SEBRING
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State | FL
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Zip | 33872-2158
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Country | US
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Telephone | 863-471-2320
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Fax | 863-471-2101
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Provider Business Mailing Address
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Address Line | 4215 SUN N LAKE BLVD
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City | SEBRING
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State | FL
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Zip | 33872-2158
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Country | US
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Telephone | 863-471-2320
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Fax | 863-471-2101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AUDWIN BRUCE NELSON
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Credential | MD
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Telephone | 863-471-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME86834
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License Number State | FL
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