Individual
NICHOLAS INGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3225 S MACDILL AVE STE 129300, TAMPA, FL 33629-8171
(813) 324-1911
Mailing address
3225 S MACDILL AVE STE 129300, TAMPA, FL 33629-8171
(813) 324-1911
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9114524
FL
Other
Enumeration date
08/20/2020
Last updated
09/19/2023
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