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NPI Code Detail

MEDICARE: MR. NICHOLAS VASILAKOS

MEDICARE: MR. NICHOLAS VASILAKOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS23559FL

General Provider Information

NPI Number : 1154607414
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NICHOLAS VASILAKOS
Provider Business Mailing Address
First Line : 9220 LITTLE RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34654-4222
Country : US
Telephone Number : 727-862-8537
Fax Number :
Provider Business Practice Location Address
First Line : 9220 LITTLE RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34654-4222
Country : US
Telephone Number : 727-862-8537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 10/31/2011

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Directions to “ MR. NICHOLAS VASILAKOS ” Practice Location

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