Healthcare Provider Details

I. General information

NPI: 1215408067
Provider Name (Legal Business Name): NICHOLAS JOHN ANDROPOULOS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8142 BELLARUS WAY STE 104
TRINITY FL
34655-1799
US

IV. Provider business mailing address

8142 BELLARUS WAY STE 104
TRINITY FL
34655-1799
US

V. Phone/Fax

Practice location:
  • Phone: 727-202-1303
  • Fax: 727-835-7955
Mailing address:
  • Phone: 727-202-1303
  • Fax: 727-835-7955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11041
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: