Individual
NICOLE E MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 461-8537
Mailing address
PO BOX 17308, CLEARWATER, FL 33762-0308
(904) 482-1070
(904) 482-1077
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME108840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003692900
—
FL
01
—
14E6P
BCBS FL
FL
Enumeration date
06/26/2008
Last updated
01/03/2012
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