Healthcare Provider Details

I. General information

NPI: 1598688111
Provider Name (Legal Business Name): NICOLE HEALTHER TOMARAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE # 2346
STUART FL
34994-2346
US

IV. Provider business mailing address

1674 SW CALIFORNIA BLVD
PORT ST LUCIE FL
34953-1739
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-5200
  • Fax:
Mailing address:
  • Phone: 561-985-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049638
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: