| Sharon Nickell-olm M D Family Medical Center, Llc | |
|
2000 Prevatt St Eustis FL 32726-6149 | |
| (352) 357-2600 | |
| (352) 357-3400 |
| Full Name | Sharon Nickell-olm M D Family Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 Prevatt St, Eustis, Florida |
| Authorized Official Name and Position | Sharon Ann Nickell-olm (MD) |
| Authorized Official Contact | 3523572600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sharon Nickell-olm M D Family Medical Center, Llc 2000 Prevatt St Eustis FL 32726-6149 Ph: (352) 357-2600 | Sharon Nickell-olm M D Family Medical Center, Llc 2000 Prevatt St Eustis FL 32726-6149 Ph: (352) 357-2600 |
| NPI Number | 1114355708 |
|---|---|
| Provider Enumeration Date | 10/17/2013 |
| Last Update Date | 05/08/2018 |
| Medicare PECOS PAC ID | 7618104605 |
|---|---|
| Medicare Enrollment ID | O20131219000784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114355708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Debbie J Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912903592 PECOS PAC ID: 9234130170 Enrollment ID: I20070120000027 |
| Provider Name | Sharon Ann Nickell-olm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407076052 PECOS PAC ID: 1355477241 Enrollment ID: I20100330001023 |
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