Provider Demographics
NPI:1629036025
Name:NELSON, JOE ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:ALAN
Last Name:NELSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 N UNIVERSITY DR
Mailing Address - Street 2:#228
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7029
Mailing Address - Country:US
Mailing Address - Phone:954-553-1066
Mailing Address - Fax:
Practice Address - Street 1:934 N UNIVERSITY DR
Practice Address - Street 2:#228
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7029
Practice Address - Country:US
Practice Address - Phone:954-553-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4921207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services