Individual
NICHOLAS SUITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2525 EMBASSY DR STE 5, HOLLYWOOD, FL 33026-4573
(305) 382-1005
Mailing address
2525 EMBASSY DR STE 5, HOLLYWOOD, FL 33026-4573
(305) 382-1005
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5315029864
MI
Other
Enumeration date
10/17/2006
Last updated
09/14/2021
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