Individual
DR. NICHOLAS BOTTARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., M.H.S.A.
Contact information
Practice address
15123 OGDEN LOOP, ODESSA, FL 33556-4633
(860) 268-6617
Mailing address
15123 OGDEN LOOP, ODESSA, FL 33556-4633
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS14898
FL
207WX0120X
Cornea and External Diseases Specialist Physician
OS14898
FL
Other
Enumeration date
05/26/2016
Last updated
01/30/2025
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