Individual
TANSYLA KEELS NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
651 N ALAFAYA TRL, ORLANDO, FL 32828-7045
(407) 273-4132
(407) 273-4725
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A83966
CA
208000000X
Pediatrics Physician
Primary
ME101521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009347000
—
FL
Enumeration date
11/01/2006
Last updated
12/09/2024
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