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Contact Information

GERALD L NICKERSON JR, MD
333 TAMIAMI TRL S STE 101
VENICE, FL34285
 Phone: 941-375-3006
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for GERALD L NICKERSON JR · (Male)

NPI Number 1932127768
Status Active
Credentials MD
Entity Individual
Enumeration date 07/18/2006
Last updated 12/15/2023 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME95990
  • LA License # 11047R
  • FL Medicaid 277901300
  • LA Medicaid 1999989
Hospital affiliation(s)
  • VENICE REGIONAL MEDICAL CENTER - (Acute Care)
    540 THE RIALTO
    VENICE, FL 34285
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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