Provider Demographics
NPI:1760606859
Name:NADLER, JON ERIK
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:ERIK
Last Name:NADLER
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 1:4544 TRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-3160
Mailing Address - Country:US
Mailing Address - Phone:407-657-7447
Mailing Address - Fax:
Practice Address - Street 1:4544 TRESCOTT DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-3160
Practice Address - Country:US
Practice Address - Phone:407-657-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8623174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian