Provider Demographics
NPI:1003215971
Name:PARRA, NELSON
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:
Last Name:PARRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4446 ANDOVER CAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-2709
Mailing Address - Country:US
Mailing Address - Phone:407-405-8090
Mailing Address - Fax:
Practice Address - Street 1:4446 ANDOVER CAY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-2709
Practice Address - Country:US
Practice Address - Phone:407-405-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health