Individual
MR. JUAN CARLOS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAED CAP
Contact information
Practice address
4422 E COLUMBUS DR, TAMPA, FL 33605-3233
(813) 384-4121
Mailing address
4422 E COLUMBUS DR, TAMPA, FL 33605-3233
(813) 384-4121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4983
FL
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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