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General NPI Number Information
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NPI Number | 1770590366
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Entity Type | Individual
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Provider Name | NICHOLE ELLA ROBINSON D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 551 NATIONAL HEALTH CARE DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1495
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Country | US
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Telephone | 386-323-7500
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Fax | 386-323-7593
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Provider Business Mailing Address
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Address Line | 3425 S ATLANTIC AVE APT 1205
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City | DAYTONA BEACH SHORES
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State | FL
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Zip | 32118-6366
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Country | US
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Telephone | 386-756-8358
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Fax | 253-484-9428
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | OS8135
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License Number State | FL
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