Individual
NICOLE BEATON SUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136
(305) 243-6732
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME132266
FL
Other
Enumeration date
04/01/2013
Last updated
06/20/2018
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