MEDICARE: JAMES MCNICHOL

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
1	224Y00000X	Clinical Exercise Physiologist		FL

General Provider Information

NPI Number	:	1275480741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MCNICHOL

Provider Business Mailing Address
First Line	:	5749 OAKDALE RD
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-8355
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 CELEBRATION BLVD STE 200
Second Line	:
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5165
Country	:	US
Telephone Number	:	407-934-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “ JAMES MCNICHOL ” Practice Location

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