Provider Demographics
NPI:1356899710
Name:HORESOVSKA, NICOLA
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:
Last Name:HORESOVSKA
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 1:1941 WASHINGTON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6045
Mailing Address - Country:US
Mailing Address - Phone:561-222-0381
Mailing Address - Fax:
Practice Address - Street 1:1941 WASHINGTON ST APT 7
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6045
Practice Address - Country:US
Practice Address - Phone:561-222-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other