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General NPI Number Information
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NPI Number | 1679394811
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Entity Type | Organization
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Legal Business Name | NICHOLAS FORT, M.D., P.A.
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 6262 SUNSET DR STE 301
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4843
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Country | US
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Telephone | 305-209-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 6262 SUNSET DR STE 301
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4843
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Country | US
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Telephone | 305-209-5522
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS FORT
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Credential | MD
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Telephone | 305-362-1056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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