Individual
JEAN NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2203 MORGANSIDE WAY, VALRICO, FL 33596-7836
(813) 822-7961
Mailing address
2203 MORGANSIDE WAY, VALRICO, FL 33596-7836
(813) 822-7961
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
L20000196536
FL
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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