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General NPI Number Information
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NPI Number | 1609260991
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Entity Type | Individual
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Provider Name | NOURA NICKEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 501 6TH AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4634
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Country | US
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Telephone | 727-767-4106
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Fax |
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Provider Business Mailing Address
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Address Line | 3524 MARLINSPIKE DRIVE
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City | TAMPA
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State | FL
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Zip | 33607
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Country | US
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Telephone | 502-439-4120
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | ME134943
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License Number State | FL
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