Provider Demographics
NPI:1740348184
Name:PARMIGIANO, NICHOLAS MICHAEL (MSPT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MICHAEL
Last Name:PARMIGIANO
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7361 SE CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-5885
Mailing Address - Country:US
Mailing Address - Phone:772-485-9447
Mailing Address - Fax:772-781-8801
Practice Address - Street 1:7361 SE CONCORD PL
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-5885
Practice Address - Country:US
Practice Address - Phone:772-485-9447
Practice Address - Fax:772-781-8801
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3229Medicare ID - Type Unspecified