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General NPI Number Information
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NPI Number | 1336704857
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Entity Type | Individual
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Provider Name | MONIQUE NELSON APRN
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Gender | Female
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 102 W PINELOCH AVE
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City | ORLANDO
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State | FL
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Zip | 32806-6100
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Country | US
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Telephone | 407-635-5060
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Fax | 321-842-9869
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Provider Business Mailing Address
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Address Line | 102 W PINELOCH AVE
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City | ORLANDO
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State | FL
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Zip | 32806-6100
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Country | US
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Telephone | 407-635-5060
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Fax | 321-842-9869
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9414396
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9414396
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License Number State | FL
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