Individual
HENRY N NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 HICKORY ST, MELBOURNE, FL 32901-1946
(321) 725-4500
(321) 951-3124
Mailing address
200 E SHERIDAN RD, MELBOURNE, FL 32901-3142
(321) 725-4500
(321) 951-3124
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME36295
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020009895
RR MEDICARE
FL
05
—
039788100
—
FL
Enumeration date
12/01/2005
Last updated
07/10/2008
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