Individual
MR. NICOLAS ALONZO BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., ED.S.
Contact information
Practice address
4150 FORD STREET EXTENSION, FORT MYERS, FL 33916
(239) 461-8388
(239) 790-5121
Mailing address
4150 FORD STREET EXTENTION, FORT MYERS, FL 33916
(239) 461-8388
(239) 790-5121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH9380
FL
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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