Provider Demographics
NPI:1851316772
Name:GAHHOS, F NICHOLAS (MD)
Entity Type:Individual
Prefix:
First Name:F
Middle Name:NICHOLAS
Last Name:GAHHOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
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
Practice Address - Country:US
Practice Address - Phone:941-484-6836
Practice Address - Fax:941-484-9690
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL44686208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79878ZOtherBC/BS PTAN
FL1689950727OtherGROUP NPI NUMBER
240006370OtherRAILROAD MEDICARE
FL1851316772OtherINDIVIDUAL NPI NUMBER
FL79878ZOtherBC/BS PTAN