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General NPI Number Information
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NPI Number | 1609935550
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Entity Type | Individual
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Provider Name | NICOLE MARRO SEMASKVICH APRN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1755 N FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33805-3109
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Country | US
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Telephone | 863-904-6201
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Fax | 866-264-2519
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Provider Business Mailing Address
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Address Line | 7302 KINARD RD
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City | PLANT CITY
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State | FL
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Zip | 33565-3658
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Country | US
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Telephone | 813-440-9504
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN390
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9286557
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9286557
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License Number State | FL
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