Healthcare Provider Details

I. General information

NPI: 1528472032
Provider Name (Legal Business Name): NICOLE MALINDA MURRAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 OVIEDO MALL BLVD
OVIEDO FL
32765-7425
US

IV. Provider business mailing address

701 AMBERLY JEWEL WAY
OVIEDO FL
32765-4609
US

V. Phone/Fax

Practice location:
  • Phone: 321-338-8609
  • Fax: 321-335-7227
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number19860
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number33452
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number19860
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: