=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699076018
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NADAR, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2010
-----------------------------------------------------
Last Update Date | 11/17/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29452 DUNCAN TRCE
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33545-4107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-766-5511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29452 DUNCAN TRCE
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33545-4107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-766-5511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. NATASHA LEWIS-COX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-766-5511
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | L10000016865
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------