Provider Demographics
NPI:1306183256
Name:KOKONIS, NECTARIOS (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:NECTARIOS
Middle Name:
Last Name:KOKONIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11566 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3019
Mailing Address - Country:US
Mailing Address - Phone:561-775-1027
Mailing Address - Fax:561-628-8936
Practice Address - Street 1:11566 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33408-3019
Practice Address - Country:US
Practice Address - Phone:561-775-1027
Practice Address - Fax:561-628-8936
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist