Organization
EDDISON NELSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDISON NELSON (OWNER)
(727) 623-2267
Entity
Organization
Contact information
Practice address
1292 DORCHESTER ST, PORT CHARLOTTE, FL 33952-2512
(727) 623-2267
Mailing address
1292 DORCHESTER ST, PORT CHARLOTTE, FL 33952-2512
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906576
FL
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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