Individual
SAGE EMIL NICOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
15116 MESA DR, APT 725, HUMBLE, TX 77396-2394
(734) 837-5481
Mailing address
5213 RESEDA DR, NEW PORT RICHEY, FL 34652-6275
(404) 405-1741
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
226086
TX
164W00000X
Licensed Practical Nurse
Primary
PN5226139
FL
Other
Enumeration date
07/12/2012
Last updated
05/29/2017
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