Provider Demographics
NPI:1659429173
Name:BORST, NICOLE MICHELLE (DO)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MICHELLE
Last Name:BORST
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:DHAON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, DO
Mailing Address - Street 1:3210 SW 33RD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7409
Mailing Address - Country:US
Mailing Address - Phone:352-237-7171
Mailing Address - Fax:888-977-1998
Practice Address - Street 1:3210 SW 33RD RD STE 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7409
Practice Address - Country:US
Practice Address - Phone:352-237-7171
Practice Address - Fax:352-237-0893
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14803207R00000X, 208M00000X, 207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology