Individual
CAMERON LEE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22655 BAYSHORE RD STE 110, PORT CHARLOTTE, FL 33980-2005
(941) 235-4900
(941) 235-4901
Mailing address
P.O. BOX 2147, FT MYERS, FL 33902-2147
(239) 343-5553
(239) 343-5321
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
57.006511
OH
208000000X
Pediatrics Physician
Primary
ME102793
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000452700
—
FL
Enumeration date
03/20/2008
Last updated
06/27/2024
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