Provider Demographics
NPI:1598857294
Name:NICOLOFF, ZULIMA A (MD)
Entity Type:Individual
Prefix:MRS
First Name:ZULIMA
Middle Name:A
Last Name:NICOLOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568217
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-8217
Mailing Address - Country:US
Mailing Address - Phone:407-855-1520
Mailing Address - Fax:407-855-1590
Practice Address - Street 1:3802 OAKWATER CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6200
Practice Address - Country:US
Practice Address - Phone:407-855-1520
Practice Address - Fax:407-855-1590
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049316207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1326130808OtherNPPES
FL058026100Medicaid
FLDQ4812OtherMEDICARE RAILROAD
FL058026100Medicaid
FL14550ZMedicare PIN