Individual provider Active NPI

Laurenzco Nicholson, MD

  • Family Medicine Physician
  • Naples, FL
National Provider Identifier
1821655929
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME156999 Issued in FL
Practice address
730 Goodlette-Frank Rd N Ste 100
Naples, FL 34102-5617
Phone
(239) 351-2990
Fax
(239) 300-4128
NPI assigned
May 23, 2019
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15221-I PR
Family Medicine Physician 207Q00000X ME156999 FL Primary

Addresses

Primary practice location

730 Goodlette-Frank Rd N Ste 100
Naples, FL 34102-5617

Mailing address

PO Box 25487
Sarasota, FL 34277-2487
Phone (941) 202-5342

Other practice location 1

7273 Vanderbilt Beach Rd Ste 28
Naples, FL 34119-1479
Phone (239) 306-5390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220824003647 FL Practitioner - Family Practice 7416331426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

730 Goodlette Rd
Suite 100
Naples, FL 34102-5617
Phone (239) 351-2990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15221-IPRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists, LLC Family Medicine CurrentSince Aug 29, 2022 Accepting new patients
Florida Medical Specialists LLC CurrentSince Aug 29, 2022 Accepting new patients
Concilio de Salud Integral de Loiza PastSince Nov 1, 2019 Accepting new patients
Florida Medical Specialists LLC Family Medicine Past Accepting new patients
Best Value Healthcare LLC Past Accepting new patients
Servicios Medicos Universitarios Inc Student in an Organized Health Care Education/Training Program Past Accepting new patients

Locations

7273 Vanderbilt Beach Rd
Ste 28
Naples, FL 34119
Phone (239) 306-5390

730 Goodlette Rd
Ste 100
Naples, FL 34102
Phone (239) 263-0849

730 Goodlette Rd
Ste 200
Naples, FL 34102
Phone (239) 659-6400

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1821655929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25487",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342772487",
            "telephone_number": "941-202-5342",
            "fax_number": "855-253-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GOODLETTE-FRANK RD N STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025617",
            "telephone_number": "239-351-2990",
            "fax_number": "239-300-4128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7273 Vanderbilt Beach Rd Ste 28",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341191479",
            "country_code": "US",
            "telephone_number": "239-306-5390",
            "fax_number": "239-306-5399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LAURENZCO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15221-I",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME156999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.