Provider Demographics
NPI:1790923134
Name:METIKOS, NEVENKA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NEVENKA
Middle Name:
Last Name:METIKOS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 NW 2ND AVE
Mailing Address - Street 2:#611
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5700 NW 2ND AVE
Practice Address - Street 2:#611
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4803
Practice Address - Country:US
Practice Address - Phone:561-703-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9205027363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner