Provider Demographics
NPI:1689950727
Name:F NICHOLAS GAHHOS MD PA
Entity Type:Organization
Organization Name:F NICHOLAS GAHHOS MD PA
Other - Org Name:F. NICHOLAS GAHHOS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:F
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:GAHHOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-484-6836
Mailing Address - Street 1:135 SAN MARCO DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-3231
Mailing Address - Country:US
Mailing Address - Phone:941-484-6836
Mailing Address - Fax:941-484-9690
Practice Address - Street 1:135 SAN MARCO DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-3231
Practice Address - Country:US
Practice Address - Phone:941-484-6836
Practice Address - Fax:941-484-9690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME446862086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1851316772OtherF. NICHOLAS GAHHOS, M.D./INDIVIDUAL NPI
FLU86380Medicare UPIN