Doctor Name: | LARS SPENCER NELSON |
NPI Number: | 1780813592 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME123398 |
Business Practice Address: | 2820 Se 3rd Ct Ste 100 Ocala, FL - 344710442 |
Business Phone Number: | 3523515770 |
Business Fax Number: | 3526293145 |
Mailing Address: | 2820 Se 3rd Ct Ste 100, OCALA |
State: | FL |
Postal Code: | 344710442 |
Phone Number: | 3523515770 |
Fax Number: | 3526293145 |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 02/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | ME123398 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |