Provider Demographics
NPI:1275067852
Name:ENCARNACION, NICOLE (MSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616506
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6506
Mailing Address - Country:US
Mailing Address - Phone:407-362-9313
Mailing Address - Fax:
Practice Address - Street 1:5001 W ROBINSON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-1693
Practice Address - Country:US
Practice Address - Phone:407-362-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator