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NPI Code Detail

MEDICARE: DR. CARLA NELSON MD

MEDICARE:  DR. CARLA  NELSON  MD
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
1208000000XPediatrics PhysicianME134387FL
2208000000XPediatrics PhysicianA101230CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902065279
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLA NELSON MD
Provider Business Mailing Address
First Line : FILE 73679 BOX 60000
Second Line :
City : SAN FRANISCO
State : CA
Zip : 94160-0000
Country : US
Telephone Number : 707-464-1989
Fax Number : 707-464-9593
Provider Business Practice Location Address
First Line : 1000 MAR WALT DR
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-6708
Country : US
Telephone Number : 808-938-3083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2008
Last Update Date : 03/09/2026

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Directions to “ DR. CARLA NELSON MD” Practice Location

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