Individual
MR. NICHOLAS JOHN LAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
801 W FRIBLEY ST, TAMPA, FL 33603-5413
(813) 294-5800
Mailing address
801 W FRIBLEY ST, TAMPA, FL 33603-5413
(813) 294-5800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA31275
FL
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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