MEDICARE: MR. NICHOLAS ALLAN HUNDLEY MSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	SW24996	FL

General Provider Information

NPI Number	:	1548908973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS ALLAN HUNDLEY MSW

Provider Business Mailing Address
First Line	:	2441 W STATE ROAD 426 STE 1051
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-4516
Country	:	US
Telephone Number	:	407-365-1199
Fax Number	:

Provider Business Practice Location Address
First Line	:	2441 W STATE ROAD 426 STE 1051
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-4516
Country	:	US
Telephone Number	:	407-365-1199
Fax Number	:

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

Provider Enumeration Date	:	05/25/2022
Last Update Date	:	07/11/2025

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