Provider Demographics
NPI:1275561466
Name:NADELL, JAMES (CP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:NADELL
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 SW 185TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7329
Mailing Address - Country:US
Mailing Address - Phone:305-259-6433
Mailing Address - Fax:
Practice Address - Street 1:8240 SW 185TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7329
Practice Address - Country:US
Practice Address - Phone:305-259-6433
Practice Address - Fax:305-251-5978
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0004754103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL680013229OtherRAILROAD MEDICARE
FL033137OtherNEIGHBORHOOD HEALTH
FLN196400OtherSTAYWEL HEALTH PLAN
FLN196400OtherHEALTHEASE
FL267440OtherAVMED
FL54341OtherBLUE CROSS & BLUE SHIELD
FLN196400OtherWELLCARE
FLOTH000Medicare UPIN
FL54341OtherBLUE CROSS & BLUE SHIELD