Healthcare Provider Details

I. General information

NPI: 1902735152
Provider Name (Legal Business Name): NICOLE TOPP PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 SHERIDAN RD
MELBOURNE FL
32901-3226
US

IV. Provider business mailing address

611 SHERIDAN RD
MELBOURNE FL
32901-3226
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-5231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT40420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: