Individual
NICHOLAS E KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5802 N 30TH ST, TAMPA, FL 33610-1469
(813) 328-8714
(813) 873-0306
Mailing address
215 N HOWARD AVE STE 101, TAMPA, FL 33606-1574
(813) 328-8714
(813) 873-0306
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME104572
FL
207LA0401X
Addiction Medicine (Anesthesiology) Physician
ME104572
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME104572
FL
208VP0000X
Pain Medicine Physician
ME104572
FL
208VP0014X
Interventional Pain Medicine Physician
ME104572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1461R
FLORIDA BLUE
FL
Enumeration date
05/10/2007
Last updated
02/22/2021
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