MEDICARE: JOHN NIVEN M.D.

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
1	207N00000X	Dermatology Physician	ME20864	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336167634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN NIVEN M.D.

Provider Business Mailing Address
First Line	:	1111 LINCOLN RD
Second Line	:	375
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2452
Country	:	US
Telephone Number	:	305-672-7058
Fax Number	:	305-672-7969

Provider Business Practice Location Address
First Line	:	1111 LINCOLN RD
Second Line	:	375
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2452
Country	:	US
Telephone Number	:	305-672-7058
Fax Number	:	305-672-7969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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