MEDICARE: NICOLE MILLS PTA

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	225200000X	Physical Therapy Assistant	28308	FL

General Provider Information

NPI Number	:	1891648168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MILLS PTA

Provider Business Mailing Address
First Line	:	4571 CAVIAR ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-1433
Country	:	US
Telephone Number	:	941-917-7600
Fax Number	:	941-917-7603

Provider Business Practice Location Address
First Line	:	5880 RAND BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-5118
Country	:	US
Telephone Number	:	941-917-7600
Fax Number	:	941-917-7603

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

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ NICOLE MILLS PTA” Practice Location

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