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NPI Code Detail

MEDICARE: NICHOLAS TIMOTHY JANK

MEDICARE: NICHOLAS TIMOTHY JANK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT40412FL

General Provider Information

NPI Number : 1023707981
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS TIMOTHY JANK
Provider Business Mailing Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number : 941-960-4741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2023
Last Update Date : 11/06/2023

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Directions to “ NICHOLAS TIMOTHY JANK ” Practice Location

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