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General NPI Number Information
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NPI Number | 1790735132
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Entity Type | Individual
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Provider Name | NICODEMO MACRI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2255 CENTERVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-386-4054
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Fax |
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Provider Business Mailing Address
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Address Line | 6218 PINE FAIR WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32309-2051
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Country | US
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Telephone | 850-386-4054
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME68962
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License Number State | FL
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