Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marilin Nicholson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083078604

Marilin Nicholson, MD is an Urology in Tampa, Florida. Qualified in 2004, 22 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
22
Licensed in
FL
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-7365
Fax: (813) 449-8618
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 200 3rd Ave W Ste 210, Bradenton, FL 34205-8633 — (941) 792-0340
  • 185 S Orange Ave, Newark, NJ 07103-2757 — (973) 972-6639

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence ME155173 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083078604
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 9, 2016
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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