MEDICARE: DR. NICHAEL ARMAND SA-C,IMG

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	246ZC0007X	Surgical Assistant	20-525	WI

General Provider Information

NPI Number	:	1598432312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHAEL ARMAND SA-C,IMG

Provider Business Mailing Address
First Line	:	331 NW 148TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33168-4243
Country	:	US
Telephone Number	:	786-376-1643
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 NW 148TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33168-4243
Country	:	US
Telephone Number	:	786-376-1643
Fax Number	:

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

Provider Enumeration Date	:	08/28/2021
Last Update Date	:	08/28/2021

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