Provider Demographics
NPI:1437577236
Name:FORT, NICHOLAS MCLAURY (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MCLAURY
Last Name:FORT
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 1:6262 SUNSET DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4843
Mailing Address - Country:US
Mailing Address - Phone:305-209-5522
Mailing Address - Fax:305-443-9767
Practice Address - Street 1:6262 SUNSET DR STE 301
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4843
Practice Address - Country:US
Practice Address - Phone:305-209-5522
Practice Address - Fax:305-443-9767
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142062207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery