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NPI Code Detail

MEDICARE: DR. FREDERICK JOSE NIN D.D.S

MEDICARE: DR. FREDERICK JOSE NIN D.D.S
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
11223G0001XGeneral Practice DentistryDN13234FL

General Provider Information

NPI Number : 1326256934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICK JOSE NIN D.D.S
Provider Business Mailing Address
First Line : 9425 NE 6TH AVE
Second Line :
City : MIAMI SHORES
State : FL
Zip : 33138-2737
Country : US
Telephone Number : 305-758-8755
Fax Number : 305-758-8740
Provider Business Practice Location Address
First Line : 9425 NE 6TH AVE
Second Line :
City : MIAMI SHORES
State : FL
Zip : 33138-2737
Country : US
Telephone Number : 305-758-8755
Fax Number : 305-758-8740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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