Provider Demographics
NPI:1689487324
Name:PAPADIMITRIOU, NELIDA (CPE, LE)
Entity type:Individual
Prefix:
First Name:NELIDA
Middle Name:
Last Name:PAPADIMITRIOU
Suffix:
Gender:F
Credentials:CPE, LE
Other - Prefix:
Other - First Name:NELIDA
Other - Middle Name:
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPE, LE
Mailing Address - Street 1:1232 RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825
Mailing Address - Country:US
Mailing Address - Phone:917-656-1785
Mailing Address - Fax:
Practice Address - Street 1:1232 RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825
Practice Address - Country:US
Practice Address - Phone:917-656-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLEO2185174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist