Individual
VICTORIA NINON OLIVIA NIKLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1717 S. ORANGE AVE., SUITE 100, NEMOURS CHILDRENS CLINIC, ORLANDO, ORLANDO, FL 32806-2946
(407) 650-7715
(407) 650-7124
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(407) 650-7129
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
G70526
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME113726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G705260
—
CA
Enumeration date
09/02/2006
Last updated
09/06/2012
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