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General NPI Number Information
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NPI Number | 1205821808
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Entity Type | Individual
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Provider Name | RONALD DAVID NELSON PHARM.D., BCPP
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 2900 VETERANS WAY
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City | VIERA
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State | FL
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Zip | 32940-8007
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Country | US
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Telephone | 321-637-3788
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Fax | 321-637-3570
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Provider Business Mailing Address
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Address Line | 9 S PALMWAY AVE
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2841
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Country | US
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Telephone | 206-850-6380
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Fax | 321-637-3570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | PH00040757
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 1163603
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License Number State | MN
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