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General NPI Number Information
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NPI Number | 1881650836
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Entity Type | Organization
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Legal Business Name | JAMES J NELSON MD PA
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/26/2011
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Provider Practice Location Address
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Address Line | 3720 NW 83RD ST
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City | GAINESVILLE
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State | FL
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Zip | 32606-5603
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Country | US
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Telephone | 352-336-3050
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Fax | 352-337-2571
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Provider Business Mailing Address
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Address Line | 4621 NW 71ST BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32606-3947
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Country | US
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Telephone | 352-339-6212
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Fax | 352-337-2571
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES J NELSON
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Credential | MD
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Telephone | 352-339-6212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME0029079
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License Number State | FL
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