Provider Demographics
NPI:1891066759
Name:HINDS, NICOLE A (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:HINDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:ANN-MARIE
Other - Last Name:ALLEYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1324 LAKELAND HILLS BLVD.
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5135 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-0514
Practice Address - Country:US
Practice Address - Phone:863-284-5000
Practice Address - Fax:863-413-4718
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131788208000000X
PAMD446311208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics