MEDICARE: FELICIA 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
1	172A00000X	Driver	N238385036000	FL

General Provider Information

NPI Number	:	1760292007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA NELSON

Provider Business Mailing Address
First Line	:	924 38TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4008
Country	:	US
Telephone Number	:	772-282-4939
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 38TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4008
Country	:	US
Telephone Number	:	772-282-4939
Fax Number	:

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

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	01/09/2025

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Directions to “ FELICIA NELSON ” Practice Location

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