Individual
NICOLE DANIELLE PREMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD DEPT OF, GAINESVILLE, FL 32610-3003
(352) 265-0077
Mailing address
752 TURKEY CRK, ALACHUA, FL 32615-9311
(720) 352-4998
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME155371
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/19/2018
Last updated
07/13/2022
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