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General NPI Number Information
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NPI Number | 1063210524
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Entity Type | Organization
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Legal Business Name | NUCLEUS MEDICAL INC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 4850 W OAKLAND PARK BLVD STE 202
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-7260
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Country | US
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Telephone | 305-924-7726
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Fax |
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Provider Business Mailing Address
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Address Line | 12941 NW 2ND ST APT 204
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2233
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BIJU ANTONY
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Credential |
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Telephone | 305-924-7726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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