Individual
NICCOS JOHN DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
643 CAPE CORAL PKWY E, SUTIE D, CAPE CORAL, FL 33904-8549
(239) 542-3581
(239) 542-4725
Mailing address
643 CAPE CORAL PKWY E, SUTIE D, CAPE CORAL, FL 33904-8549
(239) 542-3581
(239) 542-4725
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3227
FL
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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