Provider Demographics
NPI:1346764354
Name:NELSON L. HADLER, LLC
Entity Type:Organization
Organization Name:NELSON L. HADLER, LLC
Other - Org Name:NELSON L. HADLER, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HADLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-713-7957
Mailing Address - Street 1:4118 NW 11TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-9144
Mailing Address - Country:US
Mailing Address - Phone:973-713-7957
Mailing Address - Fax:
Practice Address - Street 1:8192 COLLEGE PKWY STE B52
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-5179
Practice Address - Country:US
Practice Address - Phone:973-713-7951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty