Mavrides, Nicole Ann

Mavrides, Nicole Ann is an sole proprietor health care provider with primary practice located at 1120 Nw 14Th St Suite 1466, Miami FL 33136-2107. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Mavrides, Nicole Ann can be contacted via phone (305) 243-2861.

Contact Information

Primary practice address
1120 Nw 14Th St Suite 1466 Miami FL 33136-2107
Phone: (305) 243-2861
Fax: (305) 243-8532
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 250167 New York
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME 111503 Florida
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X ME 111503 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME 111503 Florida

Profile Details

NPI number 1205044476
LBN Legal business name Mavrides, Nicole Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 19th, 2007
Last updated Sep 4th, 2014 - about 11 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 1205044476 NPPES
New York Other 250167 NY STATE LICENSE
New York Other ME 111503 NY STATE LICENSE
New York MEDICAID 004138900 NY STATE LICENSE

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