MEDICARE: CARA R NELSON-JAMES DO

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	207Q00000X	Family Medicine Physician	0S9457	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	55032	OTHER	FL	BCBS OF FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942212592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA R NELSON-JAMES DO

Provider Business Mailing Address
First Line	:	47 5TH ST NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4672
Country	:	US
Telephone Number	:	866-234-8534
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 DUNDEE RD
Second Line	:
City	:	DUNDEE
State	:	FL
Zip	:	33838-4198
Country	:	US
Telephone Number	:	866-234-8534
Fax Number	:

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	08/31/2022

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