Individual
MICHAEL FITZROY NIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-5404
(352) 392-9887
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-5404
(352) 392-9687
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW10465
FL
1041C0700X
Clinical Social Worker
LC303213
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC303213
SOCIAL WORK LICENSE
DC
Enumeration date
02/05/2008
Last updated
12/12/2011
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