Healthcare Provider Details

I. General information

NPI: 1972427623
Provider Name (Legal Business Name): NICOLE DANIELLE PYLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 QUAIL DR
MERRITT ISLAND FL
32953-4644
US

IV. Provider business mailing address

265 QUAIL DR
MERRITT ISLAND FL
32953-4644
US

V. Phone/Fax

Practice location:
  • Phone: 321-537-2211
  • Fax:
Mailing address:
  • Phone: 321-537-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11049838
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: