Provider Demographics
NPI:1942536289
Name:SHULMAN, NICOLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 S CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9231
Mailing Address - Country:US
Mailing Address - Phone:954-942-0394
Mailing Address - Fax:
Practice Address - Street 1:1925 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6551
Practice Address - Country:US
Practice Address - Phone:954-942-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA00006641172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist