Provider Demographics
NPI:1518227594
Name:NICHOLS, ANNA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 NW 14TH ST
Mailing Address - Street 2:DEPARTMENT OF DERMATOLOGY & CUTANEOUS SURGERY,SUITE K-M
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1610
Mailing Address - Country:US
Mailing Address - Phone:305-243-6735
Mailing Address - Fax:305-243-6191
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-355-1122
Practice Address - Fax:305-355-1123
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127353207N00000X
NY283246207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology