Nickerson, Gerald L

Nickerson, Gerald L is an individual health care provider with primary practice located at 333 Tamiami Trl S Ste 101 , Venice FL 34285. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Nickerson, Gerald L can be contacted via phone (941) 375-3006.

Contact Information

Primary practice address
333 Tamiami Trl S Ste 101 Venice FL 34285
Phone: (941) 375-3006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME95990 Florida
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 11047R Louisiana
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 11047R Louisiana
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X ME95990 Florida

Profile Details

NPI number 1932127768
LBN Legal business name Nickerson, Gerald L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Dec 15th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932127768 NPPES
Louisiana MEDICAID 1999989
Louisiana MEDICAID 277901300

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