MEDICARE: NELY ALMADA VARELA LCSW

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
1	1041C0700X	Clinical Social Worker	118655	MA

General Provider Information

NPI Number	:	1427403930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELY ALMADA VARELA LCSW

Provider Business Mailing Address
First Line	:	390 PONDELLA RD STE 9
Second Line	:
City	:	N FT MYERS
State	:	FL
Zip	:	33903-4340
Country	:	US
Telephone Number	:	239-652-0260
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 PONDELLA RD STE 9
Second Line	:
City	:	N FT MYERS
State	:	FL
Zip	:	33903-4340
Country	:	US
Telephone Number	:	239-652-0260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	03/25/2020

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