MEDICARE: NICOLE WIRSHING

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	103K00000X	Behavior Analyst	1-22-58731	FL

General Provider Information

NPI Number	:	1295244697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE WIRSHING

Provider Business Mailing Address
First Line	:	250 CATALONIA AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6735
Country	:	US
Telephone Number	:	786-310-7460
Fax Number	:

Provider Business Practice Location Address
First Line	:	16304 SW 61ST LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-5822
Country	:	US
Telephone Number	:	786-247-7125
Fax Number	:

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

Provider Enumeration Date	:	09/28/2017
Last Update Date	:	01/02/2026

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Directions to “ NICOLE WIRSHING ” Practice Location

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