Individual
HEATHER BONIFAY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
151 2ND ST SW, WINTER HAVEN, FL 33880-2909
(863) 288-0960
(863) 288-0963
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103902
FL
Other
Enumeration date
10/03/2006
Last updated
12/07/2023
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