Provider Demographics
NPI:1952493132
Name:NIKOLAYEV, LILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LILIA
Middle Name:
Last Name:NIKOLAYEV
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 1:1438 TIPPERARY DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6032
Mailing Address - Country:US
Mailing Address - Phone:321-806-4551
Mailing Address - Fax:321-638-0115
Practice Address - Street 1:96 WILLARD ST
Practice Address - Street 2:SUITE 306
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7991
Practice Address - Country:US
Practice Address - Phone:321-638-0027
Practice Address - Fax:321-638-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME977342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry