Most Relevant Information
Provider Data
| NPI Number: | 1003556465 |
| Provider Name: | NICOLE FARES MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/31/2022 |
| Last Updated: | 03/31/2022 |
Provider Practice Location
1611 NW 12TH AVE
MIAMI
FL
331361005
Practice Location Phone/Fax
| Phone: | 3055856970 |
| Fax: |
Provider Mailing Location
1611 NW 12TH AVE
MIAMI
FL
331361005
Provider Mailing Phone/Fax
| Phone: | 9045343069 |
| Fax: |