1952366759 NPI number — DR. NICOLE MARIE NEDD EDD, ARNP

Table of content: DR. NICOLE MARIE NEDD EDD, ARNP (NPI 1952366759)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952366759 NPI number — DR. NICOLE MARIE NEDD EDD, ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEDD
Provider First Name:
NICOLE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
EDD, ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952366759
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5701 COLLINS AVE
Provider Second Line Business Mailing Address:
PH-9
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140-2353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-575-7150
Provider Business Mailing Address Fax Number:
305-575-7151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 NW 16TH ST
Provider Second Line Business Practice Location Address:
11A
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33125-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-575-7150
Provider Business Practice Location Address Fax Number:
305-575-7151
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  2628282 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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