Healthcare Provider Details

I. General information

NPI: 1508018235
Provider Name (Legal Business Name): NICOLE FIGUEROLA ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 10/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FLORIDA INTERNATIONAL UNIVERSITY 11200 SW 8TH STREET ZEB 256 UNIVERSITY PARK CAMPUS
MIAMI FL
33199-0001
US

IV. Provider business mailing address

9420 SW 51ST TER
MIAMI FL
33165-6404
US

V. Phone/Fax

Practice location:
  • Phone: 305-348-3398
  • Fax:
Mailing address:
  • Phone: 305-815-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL2496
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: