Individual
NIKOLAI X LINCAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST, SA-C
Contact information
Practice address
29277 US HIGHWAY 19 N # 29277, CLEARWATER, FL 33761-2102
(727) 313-4764
Mailing address
29277 US HIGHWAY 19 N # 29277, CLEARWATER, FL 33761-2102
(727) 313-4764
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-469
—
246ZS0410X
Surgical Technologist
—
—
363AS0400X
Surgical Physician Assistant
19-469
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-469
ABSA
—
Enumeration date
12/03/2019
Last updated
03/22/2024
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