Eustus S Nelson MD PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME45558 Issued in FL

Legal business name

EUSTUS S NELSON MD PA

Practice address

4215 Sun N Lake Blvd
Sebring, FL 33872-2158

Phone

(863) 382-2248

Fax

(863) 382-1242

NPI assigned

Aug 30, 2007

Last updated

Aug 30, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Noreen M Nelson, RN

Title

Office Manager

Phone

(863) 382-2248

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1306030549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722158",
            "telephone_number": "863-382-2248",
            "fax_number": "863-382-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722158",
            "telephone_number": "863-382-2248",
            "fax_number": "863-382-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUSTUS S NELSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "NOREEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "863-382-2248",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME45558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Sebring, FL
• Providers in Sebring, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.