Nicolas Etienne

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

3511 S Kings Ave
Brandon, FL 33511-7719

Phone

(609) 284-6272

NPI assigned

Oct 19, 2019

Last updated

Oct 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1386287654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117719",
            "telephone_number": "609-284-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117719",
            "telephone_number": "609-284-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "NICOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Estes, RDH
• Yanara Maria Estrada Santiago
• Jessica Estrada, PT
• Ethos Health Tampa 4 LLC
• Gislaine Etienne
• Ronney Etienne, PT
• Shanelle Etienne, D.C
• David Etter, MD
• Idania Lissette Ettienne, ARNP
• Nicole Eugenio

• Developmental Disabilities Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.