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Individual

KEVIN D NOWICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2020 OAKLEY SEAVER DR, CLERMONT, FL 34711
(352) 242-0404
(352) 242-5278
Mailing address
2020 OAKLEY SEAVER DR, CLERMONT, FL 34711
(352) 242-0404
(352) 242-5278

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
ME0062806
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
379981600
FL
Enumeration date
08/17/2005
Last updated
11/20/2013
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