Healthcare Provider Details

I. General information

NPI: 1316960883
Provider Name (Legal Business Name): JAMES SULLIVAN NOCE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 NATIONAL HEALTH CARE DR
DAYTONA BEACH FL
32114-1495
US

IV. Provider business mailing address

1244 N GRANDVIEW AVE
DAYTONA BEACH FL
32118-3651
US

V. Phone/Fax

Practice location:
  • Phone: 386-323-7500
  • Fax: 386-323-7570
Mailing address:
  • Phone: 386-679-0836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY 7290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: