Provider Demographics
NPI:1891880233
Name:NOLASCO, NAKIN (DC)
Entity Type:Individual
Prefix:DR
First Name:NAKIN
Middle Name:
Last Name:NOLASCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 BRYSON DR.
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-596-4244
Mailing Address - Fax:239-596-4204
Practice Address - Street 1:5500 BRYSON DR.
Practice Address - Street 2:SUITE 303
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-596-4244
Practice Address - Fax:239-596-4204
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71479ZMedicare ID - Type Unspecified
FLV08222Medicare UPIN