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General NPI Number Information
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NPI Number | 1558373464
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Entity Type | Individual
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Provider Name | PHILLIP A NYE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 1485 37TH ST STE 111
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City | VERO BEACH
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State | FL
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Zip | 32960-6518
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Country | US
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Telephone | 772-226-6855
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Fax | 772-226-6854
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Provider Business Mailing Address
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Address Line | 1485 37TH ST STE 111
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City | VERO BEACH
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State | FL
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Zip | 32960-6518
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Country | US
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Telephone | 772-226-6855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME95624
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | ME95624
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License Number State | FL
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