Kevin Nicholson LLC

NPI #1508209214 in Kissimmee, Florida

Provider Information

NPI Number: 1508209214
Entity Type: Organization
Organization Name: Kevin Nicholson LLC
Primary Specialty: Pediatrics
Enumeration Date: Apr 11, 2013
Last Updated: Apr 11, 2013

Practice Location

Address: 1674 PLEASANT HILL RD
City: Kissimmee
State: Florida
ZIP Code: 34746-3954
Phone: (407) 545-9191

Authorized Official

Name: DR. TANSYLA NICHOLSON, MD
Title: MEDICAL DIRECTOR
Phone: (407) 545-9191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Pediatrics	208000000X	Primary

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