Individual
DAVID S NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
403 VONDERBURG DR, STE 101, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Mailing address
403 VONDERBURG DR, STE 101, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0043731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049901
GHI
NY
01
—
0805216
UNITED HEALTHCARE
FL
01
—
2074201
AETNA
FL
01
—
30744
BCBS FLORIDA
FL
01
—
4091614
AETNA
FL
Enumeration date
07/07/2005
Last updated
09/07/2016
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