Individual
LIXON NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 NW 122ND ST, MIAMI, FL 33168
(305) 757-3372
(305) 757-3352
Mailing address
135 NW 122ND ST, NORTH MIAMI, FL 33168-4517
(305) 757-3372
(305) 757-3352
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693274696
—
FL
05
—
693274698
—
FL
Enumeration date
10/31/2008
Last updated
04/13/2011
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