DR. NICKOLAS JOHN COLLUCCI (NPI# 1811915747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811915747 |
| Entity Type | Individual |
| Full Name | DR. NICKOLAS JOHN COLLUCCI |
| Credential | D.O. |
| Practice Address |
21 Hospital Dr Suite 260 Palm Coast FL 32164-2452 |
| Mailing Address |
Po Box 279 Flagler Beach FL 32136-0279 |
| Practice Telephone | 3865865344 |
| Practice Fax Number | 3865865450 |
| Mailing Telephone | 3865865344 |
| Mailing Fax Number | 3865865450 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-04-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | OS4153 | FL | Allopathic & Osteopathic Physicians |
| Y | 202K00000X | Phlebology | OS4153 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
21 HOSPITAL DR SUITE 260 |
| City | PALM COAST |
| State | FL |
| Zip Code | 32164-2452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558802959 | Christina Ratliff | Nurse Practitioner | 21 Hospital Dr, Suite 140, Palm Coast, FL 32164-2452 | 2017-03-17 |
| 1528416096 | Advanced Urology Institute LLC | Non-Pharmacy Dispensing Site | 21 Hospital Dr, Ste 140, Palm Coast, FL 32164-2452 | 2016-05-25 |
| 1770967077 | Metcare of Palm Coast | Family Medicine | 21 Hospital Dr, Suite 125, Palm Coast, FL 32164-2452 | 2015-07-16 |
| 1891181194 | Chamion N. Olivier Md Pa | Internal Medicine | 21 Hospital Dr, Suite 290, Palm Coast, FL 32164-2452 | 2015-04-13 |
| 1033500624 | Coastal Family Healthcare LLC | Family Medicine | 21 Hospital Dr, Suite 280, Palm Coast, FL 32164-2452 | 2015-02-18 |
| 1578854477 | Florida Woman Care, LLC | Obstetrics & Gynecology | 21 Hospital Dr, Suite 270, Palm Coast, FL 32164-2452 | 2011-04-26 |
| 1326359274 | Caroline M Sargeant | Nurse Practitioner | 21 Hospital Dr, Suite 270, Palm Coast, FL 32164-2452 | 2010-06-25 |
| 1962644914 | Ips of Palm Coast LLC | Nurse Anesthetist, Certified Registered | 21 Hospital Dr, Ste 220, Palm Coast, FL 32164-2452 | 2009-04-06 |
| 1396987350 | Spinecare of Palm Coast LLC | Pain Medicine | 21 Hospital Dr, Ste 220, Palm Coast, FL 32164-2452 | 2009-04-06 |
| 1598907552 | Mua Center of Palm Coast LLC | Clinic/Center | 21 Hospital Dr, Ste 220, Palm Coast, FL 32164-2452 | 2009-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561044 | Ereka Manangan | Pharmacist | 5000 E, Fl-100, Palm Coast, FL 32164 | 2020-09-01 |
| 1427661735 | George Allen Parker | Pharmacist | 5000 E Hwy 100, Palm Coast, FL 32164 | 2020-08-26 |
| 1891318424 | Faithangel Corp | In Home Supportive Care | 125 Pine Grove Dr, Palm Coast, FL 32164 | 2020-05-18 |
| 1578101481 | Sweetie Peetie LLC | Hearing Instrument Specialist | 160 Cypress Point Parkway, Ste A108, Palm Coast, FL 32164 | 2019-12-11 |
| 1831656610 | Dolphin Medical Transport LLC | Taxi | 30 Westmoreland Dr, Palm Coast, FL 32164 | 2019-02-27 |
| 1003389024 | Southeast Snoring & Sleep Apnea Group | Durable Medical Equipment & Medical Supplies | 108 Pennacles Dr. #101, Palm Coast, FL 32164 | 2019-01-03 |
| 1801388137 | Lily Michelle King | Licensed Practical Nurse | 8 Regent Ln, Palm Coast, FL 32164 | 2018-06-01 |
| 1558880120 | Bryan Mendes | Physical Therapist | 1 Westrock Ln, Palm Coast, FL 32164 | 2017-09-14 |
| 1477077451 | Sharon Denise Astrologo | Case Manager/Care Coordinator | 421 S. Keech St., Daytona Beach, FL 32164 | 2017-08-01 |
| 1952825283 | Emily Guarino | Behavior Technician | 136a Wellwood Lane, Palm Coast, FL 32164 | 2017-07-28 |
| Find all providers in zip 32164 | ||||
| Taxonomy Code | 202K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Phlebology |
| Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism. |
| Notes: Source: American College of Phlebology 12/2006. www.phelbology.org [1/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: Training Programs, Fellowships, and/or Preceptorships: Certification exam is being established by the American Board of Phlebology. ACGME Accredited Residency Program Requirements: None |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396356788 | Jose R Rodriguez | Phlebology | 330 W 9th St Ste 5, Hialeah, FL 33010-3865 | 2020-08-11 |
| 1518582790 | Kimberly Ann Harriman | Phlebology | 3574 Lei Dr, Sarasota, FL 34232-5559 | 2020-06-12 |
| 1164043758 | Jasmine Tashawn Williams | Phlebology | 1441 Manotak Ave Apt 1613, Jacksonville, FL 32210-1071 | 2020-05-05 |
| 1710519640 | Heather Danielle Basagoitia | Phlebology | 1345 Sw 30th St, Fort Lauderdale, FL 33315-2842 | 2020-02-09 |
| 1184180739 | Lumiere Cosmetic Vein Center P A | Phlebology | 2546 Heydon Ln Ste 2, Cape Coral, FL 33991-3550 | 2019-02-19 |
| 1043774003 | Edward G Mackay, Md and Associates, LLC | Phlebology | 2863 Alternate 19 North, Palm Harbor, FL 34683 | 2019-01-24 |
| 1174087290 | Healthtrust Medical Center Corp | Phlebology | 7801 Coral Way Ste 112, Miami, FL 33155-6538 | 2019-01-23 |
| 1922589068 | Cynetra Zollicoffer | Phlebology | 10208 Douglas Oaks Cir Apt 104, Tampa, FL 33610-8651 | 2018-08-27 |
| 1144729575 | Labs At Your Door LLC | Phlebology | 4612 N Hiatus Rd, Sunrise, FL 33351-7909 | 2018-02-12 |
| 1881972347 | Veincare of Brevard, LLC | Phlebology | 2712 Newfound Harbor Dr, Merritt Island, FL 32952-2866 | 2011-08-01 |
| Find all providers with the same taxonomy | ||||
| City | PALM COAST |
| Zip Code | 32164 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.