Individual
DR. IGOR NICHIPORENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 E SAMPLE RD, DEERFIELD BEACH, FL 33064-3502
(954) 941-8300
Mailing address
2006 NE 49TH ST, FORT LAUDERDALE, FL 33308-4524
(954) 210-4120
(954) 958-0221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME107033
FL
208600000X
Surgery Physician
Primary
ME 107033
FL
2086S0127X
Trauma Surgery Physician
ME107033
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004456500
—
FL
Enumeration date
05/13/2010
Last updated
09/03/2025
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