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NPI Code Detail

MEDICARE: NILSSEN ORTHOPEDICS P A

MEDICARE: NILSSEN ORTHOPEDICS P A
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
1207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianME99816FL

General Provider Information

NPI Number : 1740426238
Entity Type Code : Organization
Provider Name (Legal Business Name) : NILSSEN ORTHOPEDICS P A
Provider Business Mailing Address
First Line : 1040 GULF BREEZE PKWY
Second Line : SUITE 200
City : GULF BREEZE
State : FL
Zip : 32561-7809
Country : US
Telephone Number : 850-916-3700
Fax Number :
Provider Business Practice Location Address
First Line : 825 E BURGESS RD
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-7001
Country : US
Telephone Number : 850-435-4800
Fax Number : 850-916-8629
Authorized Official
Title or Position : PRESIDENT
Name : ERIK C NILSSEN
Credential : MD
Telephone Number : 850-916-3700
Provider Enumeration Date : 01/05/2009
Last Update Date : 02/28/2017

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1811340078 — NILSSEN ORTHOPEDICS PA
Practice Location Address:
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Directions to “NILSSEN ORTHOPEDICS P A ” Practice Location

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