Provider Demographics
NPI:1689257552
Name:THERMIDOR, NEDJIKA SAMIRA
Entity Type:Individual
Prefix:
First Name:NEDJIKA
Middle Name:SAMIRA
Last Name:THERMIDOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8377 NW 19TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6267
Mailing Address - Country:US
Mailing Address - Phone:954-859-7011
Mailing Address - Fax:
Practice Address - Street 1:8377 NW 19TH CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6267
Practice Address - Country:US
Practice Address - Phone:954-859-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider