Provider Demographics
NPI:1598830374
Name:NICOLAS ALEXANDRE, MARIE JOCELYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:JOCELYNE
Last Name:NICOLAS ALEXANDRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6100 BLUE LAGOON DR STE 365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7010
Mailing Address - Country:US
Mailing Address - Phone:786-322-7333
Mailing Address - Fax:786-322-7329
Practice Address - Street 1:12376 QUAIL ROOST DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4974
Practice Address - Country:US
Practice Address - Phone:786-623-0994
Practice Address - Fax:786-430-8197
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0066935208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376219000Medicaid
FLC60268OtherUPIN
FLC60268OtherUPIN