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General NPI Number Information
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NPI Number | 1386639474
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEE NELSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 42 BUSINESS CENTRE DR SUITE 308
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-6920
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Country | US
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Telephone | 850-460-8778
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Fax | 850-460-8779
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Provider Business Mailing Address
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Address Line | 10301 CHAMPION FARMS DR
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City | LOUISVILLE
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State | KY
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Zip | 40241-6129
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Country | US
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Telephone | 502-423-1021
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Fax | 502-423-1416
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 37667
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 200201130
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License Number State | NC
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