EDDISON NELSON (NPI# 1881031417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881031417 |
Entity Type | Organization |
Organization Name | EDDISON NELSON |
Practice Address |
1292 Dorchester St Port Charlotte FL 33952-2512 |
Practice Telephone | 7276232267 |
Enumeration Date | 2013-05-22 |
Last Update Date | 2013-05-22 |
Authorized Official Name | EDDISON NELSON (OWNER) |
Authorized Official Telephone | 7276232267 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906576 | FL | Nursing & Custodial Care Facilities |
Street Address |
1292 DORCHESTER ST |
City | PORT CHARLOTTE |
State | FL |
Zip Code | 33952-2512 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518425081 | Annette Simmons | Custodial Care Facility | 1292 Dorchester St, Port Charlotte, FL 33954 | 2019-03-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700486552 | Arrow Medical LLC | Durable Medical Equipment & Medical Supplies | 3514 Tamiami Trail, Unit 104, Port Charlotte, FL 33952 | 2020-10-30 |
1376009621 | David Alan Mowry | Massage Therapist | 3148 Whiting Lane, Port Charlotte, FL 33952 | 2019-02-12 |
1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
1255856118 | All Powered Mobility, LLC | Durable Medical Equipment & Medical Supplies | 2765 Tamiami Trl Ste B1, Port Charlotte, FL 33952 | 2017-08-11 |
1366994915 | Julianne Kumar | Physical Medicine & Rehabilitation | 4166 Tamiami Trail, Unit A, Port Charlotte, FL 33952 | 2016-10-31 |
1659729549 | The Gathering Place LLC | Licensed Practical Nurse | 3459 Depew Ave, Port Charlotte, FL 33952 | 2016-06-01 |
1003222183 | Philip Lagamma | Physical Therapist | 4161 Tamiami Trl Ste 103, Port Charlotte, FL 33952 | 2014-07-09 |
1184039695 | Nathan E Shipley | Driver | 2338 Alton Rd., Port Charlotte, FL 33952 | 2014-06-23 |
1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
1225306475 | Tamjo Inc | Hearing Instrument Specialist | 2811 Ste. A Tamiami Trail, Port Charlotte, FL 33952 | 2011-12-02 |
Find all providers in zip 33952 |
Taxonomy Code | 311ZA0620X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Custodial Care Facility |
Specialization | Adult Care Home |
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144699646 | Raymond B Hendricks | Custodial Care Facility | 1306 Annette St, Port Charlotte, FL 33980 | 2015-09-15 |
1366864795 | Ivy Flo Moore | Custodial Care Facility | 23145 Gray Ave, Port Charlotte, FL 33980-8587 | 2014-01-21 |
1922438464 | Julliet Jackson | Custodial Care Facility | 17345 Edgewater Dr, Port Charlotte, FL 33948-2343 | 2013-11-20 |
1508203571 | Chery Adult Family Care Home | Custodial Care Facility | 1048 Renoir St, Port Charlotte, FL 33952-1762 | 2013-05-30 |
1356788996 | Jeanette Gadsden | Custodial Care Facility | 1113 Fleetwood Dr Nw, Port Charlotte, FL 33948-2001 | 2013-05-22 |
1750727061 | Spliddie Harrison | Custodial Care Facility | 23529 Quasar Blvd, Port Charlotte, FL 33980-3120 | 2013-05-14 |
1346686714 | George Harris | Custodial Care Facility | 152 Torrington St, Port Charlotte, FL 33954-2424 | 2013-05-13 |
1174969588 | Annette Angela Hughes | Custodial Care Facility | 18520 Satsuma Ave, Port Charlotte, FL 33948-7520 | 2013-05-13 |
1528404928 | Merona Grey | Custodial Care Facility | 23167 Wilkinson Ave, Port Charlotte, FL 33980-5865 | 2013-05-13 |
1538503784 | Sharon Marcia Nelson | Custodial Care Facility | 21459 Seaton Ave, Port Charlotte, FL 33954-3251 | 2013-04-18 |
Find all providers in PORT CHARLOTTE |
City | PORT CHARLOTTE |
Zip Code | 33952 |
Please comment or provide details below to improve the information on EDDISON NELSON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.