Provider Demographics
NPI:1093894354
Name:ALDERSON, NATHAN LEE (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:LEE
Last Name:ALDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5333 SW 75TH ST APT H49
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-7449
Mailing Address - Country:US
Mailing Address - Phone:352-328-1184
Mailing Address - Fax:
Practice Address - Street 1:5333 SW 75TH ST APT H49
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-7449
Practice Address - Country:US
Practice Address - Phone:352-328-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN-10104207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology