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General NPI Number Information
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NPI Number | 1184019853
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Entity Type | Organization
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Legal Business Name | NELSON T CACERES LLC
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 6021 SW 109TH AVE
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City | MIAMI
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State | FL
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Zip | 33173-1246
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Country | US
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Telephone | 305-775-1775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 831082
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City | MIAMI
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State | FL
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Zip | 33283-1082
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Country | US
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Telephone | 305-775-1775
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NELSON T CACERES
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Credential | ARNP
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Telephone | 305-775-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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