MEDICARE: NICOLE DANIELA TEK APRN

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
1	363LF0000X	Family Nurse Practitioner	11042498	FL

General Provider Information

NPI Number	:	1174484141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE DANIELA TEK APRN

Provider Business Mailing Address
First Line	:	340 W ROSS AVE APT 129
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-2061
Country	:	US
Telephone Number	:	516-510-3780
Fax Number	:

Provider Business Practice Location Address
First Line	:	3218 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3018
Country	:	US
Telephone Number	:	813-701-5804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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