MEDICARE: NICHOLAS KRASOVEC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1649114315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS KRASOVEC

Provider Business Mailing Address
First Line	:	7 WILLIAMS ST
Second Line	:
City	:	DANVERS
State	:	MA
Zip	:	01923-1921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 S DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6313
Country	:	US
Telephone Number	:	813-497-5059
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ NICHOLAS KRASOVEC ” Practice Location

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