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NPI Code Detail

MEDICARE: CYNTHIA NICHOLS RPH

MEDICARE:   CYNTHIA  NICHOLS  RPH
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
1183500000XPharmacistPS30914FL

General Provider Information

NPI Number : 1710581749
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA NICHOLS RPH
Provider Business Mailing Address
First Line : 11936 FOREST HILL BLVD
Second Line :
City : WELLINGTON
State : FL
Zip : 33414-6248
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11936 FOREST HILL BLVD
Second Line :
City : WELLINGTON
State : FL
Zip : 33414-6248
Country : US
Telephone Number : 561-793-2126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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Directions to “ CYNTHIA NICHOLS RPH” Practice Location

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