MEDICARE: MARK LINDER NELSON C.RN.A.

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	367500000X	Certified Registered Nurse Anesthetist	ARNP3069322	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00215132	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G2883	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639153463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK LINDER NELSON C.RN.A.

Provider Business Mailing Address
First Line	:	331 LEMON ST
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5249
Country	:	US
Telephone Number	:	727-418-4538
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 LEMON ST
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5249
Country	:	US
Telephone Number	:	727-418-4538
Fax Number	:

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/05/2021

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