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NPI Code Detail

MEDICARE: NICHOLAS ANTHONY JOERGER

MEDICARE: NICHOLAS ANTHONY JOERGER
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
1363A00000XPhysician AssistantFL

General Provider Information

NPI Number : 1538019229
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ANTHONY JOERGER
Provider Business Mailing Address
First Line : 148 LEADLINE LN
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-8480
Country : US
Telephone Number : 610-999-7724
Fax Number :
Provider Business Practice Location Address
First Line : 4401 N HIMES AVE STE 175
Second Line :
City : TAMPA
State : FL
Zip : 33614-7095
Country : US
Telephone Number : 610-999-7724
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ NICHOLAS ANTHONY JOERGER ” Practice Location

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