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NPI Code Detail

MEDICARE: CAMERON LEE NICHOLSON M.D.

MEDICARE: CAMERON LEE NICHOLSON M.D.
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
1208000000XPediatrics PhysicianME102793FL
2208000000XPediatrics Physician57.006511OH
32080P0207XPediatric Hematology & Oncology PhysicianME102793FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932370681
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON LEE NICHOLSON M.D.
Provider Business Mailing Address
First Line : P.O. BOX 2147
Second Line :
City : FT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-343-5553
Fax Number : 239-343-5321
Provider Business Practice Location Address
First Line : 9981 S HEALTHPARK DR STE 156
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-3618
Country : US
Telephone Number : 239-343-5333
Fax Number : 239-343-5321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2008
Last Update Date : 06/25/2026

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