Kevin Nicholson LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME101521 Issued in FL

Legal business name

KEVIN NICHOLSON LLC

Practice address

1674 Pleasant Hill Rd
Kissimmee, FL 34746-3954

Phone

(407) 545-9191

Fax

(407) 641-8918

NPI assigned

Apr 11, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Tansyla Nicholson, MD

Title

Medical Director

Phone

(407) 545-9191

Specialties & licenses 2

Addresses

Other names 1

• Doctor 2 Your Door Doing business as

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1508209214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "LOUGHMAN",
            "state": "FL",
            "postal_code": "338580407",
            "telephone_number": "407-545-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463954",
            "telephone_number": "407-545-9191",
            "fax_number": "407-641-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN NICHOLSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "TANSYLA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-545-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME101521",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME101521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctor 2 Your Door",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sean Michael Kennedy, MD
• Sherline Kenton-Morris
• Deborah Jean Kenyon, BA-HC, RN
• Jeannette R Kerns, AP, DOM, L.AC.
• Sarah Ketterman
• Key Life Concepts LLC
• Key Life Concepts LLC
• Kga Medical Supply LLC
• Galib Intisar Khalek, PHARMD
• Samer Khalil, DO

• Pediatrics Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.