Provider Demographics
NPI:1053986380
Name:NOLTE, VICTORIA (DPM)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NOLTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20900 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1495
Mailing Address - Country:US
Mailing Address - Phone:954-471-1152
Mailing Address - Fax:
Practice Address - Street 1:1601 CLINT MOORE RD STE 180
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-5713
Practice Address - Country:US
Practice Address - Phone:561-258-9423
Practice Address - Fax:561-989-0775
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPO4594213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program