Healthcare Provider Details

I. General information

NPI: 1417417486
Provider Name (Legal Business Name): NICHOLE MARCANTONIO ARTZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEE NICHOLE MARCANTONIO MD

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE STE 100
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

2900 CORPORATE WAY DOOR D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-2235
  • Fax: 954-265-6380
Mailing address:
  • Phone: 954-276-5603
  • Fax: 954-985-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME175588
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: