Individual
SHARON MARCIA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21459 SEATON AVE, PORT CHARLOTTE, FL 33954-3251
(941) 255-8260
Mailing address
21459 SEATON AVE, PORT CHARLOTTE, FL 33954-3251
(941) 255-8260
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141414300
—
FL
Enumeration date
04/18/2013
Last updated
04/18/2013
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