Provider Demographics
NPI:1770736480
Name:HUGHES, NICHOLAS JAMES (DPT)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JAMES
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 63RD DR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-7663
Mailing Address - Country:US
Mailing Address - Phone:727-510-2616
Mailing Address - Fax:727-502-6027
Practice Address - Street 1:215 63RD DR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-7663
Practice Address - Country:US
Practice Address - Phone:727-510-2616
Practice Address - Fax:727-502-6027
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BF445TMedicare PIN
HQ721AMedicare PIN
FLBF445XMedicare PIN