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NPI Code Detail

MEDICARE: JOSEPH NICOTRA M.D.

MEDICARE: JOSEPH NICOTRA 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
1207L00000XAnesthesiology PhysicianME0057051FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3050029598OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1223500OTHERAMERIGROUP
209960OTHERBC BS FL
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659351112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH NICOTRA M.D.
Provider Business Mailing Address
First Line : 2609 SE 21ST PL
Second Line :
City : CAPE CORAL
State : FL
Zip : 33904-3275
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Provider Business Practice Location Address
First Line : 12511 WORLD PLAZA LN BLDG 50
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-3991
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 02/28/2013

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Directions to “ JOSEPH NICOTRA M.D.” Practice Location

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