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General NPI Number Information
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NPI Number | 1609211747
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Entity Type | Individual
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Provider Name | NICHOLAS BERNARD SYLVAS
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Gender | Male
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 668 N ORLANDO AVE SUITE 210
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City | MAITLAND
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State | FL
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Zip | 32751-4473
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Country | US
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Telephone | 407-215-0095
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Fax |
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Provider Business Mailing Address
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Address Line | 2152 JEREMIAH WAY
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City | KISSIMMEE
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State | FL
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Zip | 34743-3718
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Country | US
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Telephone | 407-348-6574
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW3589
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License Number State | FL
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