Mark, Nicole J

Mark, Nicole J is an individual health care provider with primary practice located at 5300 W Hillsboro Blvd Suite 110, Coconut Creek FL 33073-4395. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mark, Nicole J can be contacted via phone (954) 794-1360.

Contact Information

Primary practice address
5300 W Hillsboro Blvd Suite 110 Coconut Creek FL 33073-4395
Phone: (954) 794-1360
Fax: (954) 794-1367
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OS8649 Florida

Profile Details

NPI number 1801885348
LBN Legal business name Mark, Nicole J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jun 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801885348 NPPES
Florida MEDICAID 265026600

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