Provider Demographics
NPI:1952140048
Name:DE HOYOS URIBE, NICOLLE (MSW)
Entity type:Individual
Prefix:
First Name:NICOLLE
Middle Name:
Last Name:DE HOYOS URIBE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 PROVIDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8350
Mailing Address - Country:US
Mailing Address - Phone:386-215-4878
Mailing Address - Fax:
Practice Address - Street 1:2290 N RONALD REAGAN BLVD STE 116
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3534
Practice Address - Country:US
Practice Address - Phone:407-215-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker