Provider Demographics
NPI:1053699231
Name:DINOVITSER, NICOLE S (ARNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:S
Last Name:DINOVITSER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 PALM BEACH LAKES BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3512
Mailing Address - Country:US
Mailing Address - Phone:561-509-5009
Mailing Address - Fax:561-738-1822
Practice Address - Street 1:12955 PALMS WEST DR STE 100
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9212
Practice Address - Country:US
Practice Address - Phone:561-509-5009
Practice Address - Fax:561-738-1822
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9277433364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics