Individual
MR. TERENCE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 RUFFEL ST, MAITLAND, FL 32751-6756
(305) 804-7034
Mailing address
225 RUFFEL ST, MAITLAND, FL 32751-6756
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
W264948
FL
Other
Enumeration date
11/14/2015
Last updated
11/14/2015
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