Provider Demographics
NPI:1902354061
Name:ALBERGO, NICOLE TARA (LAT, ATC, OPE-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:TARA
Last Name:ALBERGO
Suffix:
Gender:F
Credentials:LAT, ATC, OPE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 OLD ENGLISH CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7068
Mailing Address - Country:US
Mailing Address - Phone:570-269-3297
Mailing Address - Fax:
Practice Address - Street 1:2600 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2999
Practice Address - Country:US
Practice Address - Phone:561-478-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 2255A2300X
FLAL54592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program