MEDICARE: NICOLE MALINDA MURRAY M.D.

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	171M00000X	Case Manager/Care Coordinator		NJ
2	261QM2500X	Medical Specialty Clinic/Center
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207QS0010X	Sports Medicine (Family Medicine) Physician	19860	FL
5	208D00000X	General Practice Physician	33452	FL
6	172V00000X	Community Health Worker		NJ
7	208D00000X	General Practice Physician	19860	FL

General Provider Information

NPI Number	:	1528472032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MALINDA MURRAY M.D.

Provider Business Mailing Address
First Line	:	701 AMBERLY JEWEL WAY
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-4609
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 OVIEDO MALL BLVD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-7425
Country	:	US
Telephone Number	:	321-338-8609
Fax Number	:	321-335-7227

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

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	05/18/2026

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