Roberto Di Nicolo, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME0051694 Issued in FL

Practice address

353 N Clyde Morris Blvd
Sute 1
Daytona Beach, FL 32114-2732

Phone

(386) 252-6622

NPI assigned

Nov 17, 2007

Last updated

Nov 17, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Asthma Allergy & Sinus Clinic PA

  • Allergy & Immunology Physician
  • Daytona Beach, FL
  • NPI 1255460507
  Authorized official Same address or phone

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1699956789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 N CLYDE MORRIS BLVD",
            "address_2": "SUTE 1",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142732",
            "telephone_number": "386-252-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 N CLYDE MORRIS BLVD",
            "address_2": "SUTE 1",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142732",
            "telephone_number": "386-252-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI NICOLO",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME0051694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Anne Deveras, MD
• Jane A Devine, LMFT
• Patricia A. Dewees, LMFT
• Olivia Mangat Dhaliwal, MD
• Preanka Dhanoa, MD
• Diabetix (Diabetix LLC)
• Jessica Regan Diamon, SLP
• Michael A Diamond, M.D.
• Heather L Diaz
• Jessica Leeann Dickerson, A.P.

• Allergy & Immunology Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Allergy & Immunology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.