Individual
NICHOLAS STEPHEN XYNIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1414 69TH AVE W, BRADENTON, FL 34207-5850
(941) 306-4113
Mailing address
14246 TREE SWALLOW WAY, LAKEWOOD RANCH, FL 34202-8293
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
19543
FL
Other
Enumeration date
06/01/2017
Last updated
03/17/2018
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