Individual
MR. NICHOLAS R URDIALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1767 LAKEWOOD RANCH BLVD, #252, BRADENTON, FL 34211-4906
(973) 789-5148
Mailing address
3654 CORINTH PKWY, CORINTH, TX 76208-5373
(973) 789-5148
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
FL
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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