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NPI Code Detail

MEDICARE: ADANNA NELSON

MEDICARE: ADANNA NELSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1134638497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADANNA NELSON
Provider Business Mailing Address
First Line : 900 NW 31ST AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-6653
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 NW 31ST AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-6653
Country : US
Telephone Number : 954-357-7955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2017
Last Update Date : 09/29/2017

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Directions to “ ADANNA NELSON ” Practice Location

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