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NPI Code Detail

MEDICARE: NICHOLAS MYERS

MEDICARE: NICHOLAS MYERS
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 Therapist

General Provider Information

NPI Number : 1093443392
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS MYERS
Provider Business Mailing Address
First Line : 2351 N WILLIAMSON BLVD APT 13107
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32117-5912
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3901 UNIVERSITY BLVD S STE 103
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-4374
Country : US
Telephone Number : 904-345-7373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2022
Last Update Date : 08/13/2022

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Directions to “ NICHOLAS MYERS ” Practice Location

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