Provider Demographics
NPI:1942212592
Name:NELSON-JAMES, CARA R (DO)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:R
Last Name:NELSON-JAMES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4672
Mailing Address - Country:US
Mailing Address - Phone:866-234-8534
Mailing Address - Fax:
Practice Address - Street 1:916 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4198
Practice Address - Country:US
Practice Address - Phone:866-234-8534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S9457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275898900Medicaid
FL55032OtherBCBS OF FLORIDA
FLU8089YMedicare PIN
FLI60196Medicare Oscar/Certification
FLU8089WMedicare PIN
FLU8089ZMedicare PIN
FLU8089Medicare PIN
FL55032OtherBCBS OF FLORIDA
FLU8089XMedicare PIN