Provider Demographics
NPI:1306989538
Name:NIMO, WILLIAM PATRICK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:NIMO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4432 HENDRICKS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-6326
Mailing Address - Country:US
Mailing Address - Phone:904-423-0123
Mailing Address - Fax:
Practice Address - Street 1:4432 HENDRICKS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-6326
Practice Address - Country:US
Practice Address - Phone:904-423-0123
Practice Address - Fax:904-379-6446
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29194183500000X
FLPH302591835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist