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NPI Code Detail

MEDICARE: MS. MIRIAM ANNETTE NICHOLS L.C.S.W.

MEDICARE:  MS. MIRIAM ANNETTE NICHOLS  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW 4681FL

General Provider Information

NPI Number : 1205864725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MIRIAM ANNETTE NICHOLS L.C.S.W.
Provider Business Mailing Address
First Line : 1210 LENOX AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-3806
Country : US
Telephone Number : 305-788-3729
Fax Number : 305-535-8215
Provider Business Practice Location Address
First Line : 3050 BISCAYNE BLVD
Second Line : SUITE 908
City : MIAMI
State : FL
Zip : 33137-4158
Country : US
Telephone Number : 305-788-3729
Fax Number : 305-535-8215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 07/08/2007

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Directions to “ MS. MIRIAM ANNETTE NICHOLS L.C.S.W.” Practice Location

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