Provider Demographics
NPI:1053381913
Name:BIXLER, NICOLE H (DO)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:H
Last Name:BIXLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:HEATH
Other - Last Name:SIRCHIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:118 SEVEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0235
Mailing Address - Country:US
Mailing Address - Phone:352-666-6950
Mailing Address - Fax:352-666-6438
Practice Address - Street 1:118 SEVEN HILLS DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0235
Practice Address - Country:US
Practice Address - Phone:352-666-6950
Practice Address - Fax:352-666-6438
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012693207Q00000X
FLOS10103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG294ZOtherPTAN
FLI04549Medicare UPIN
FLAG294ZOtherPTAN