Provider Demographics
NPI:1407319718
Name:NOWICKI, NATALIE NICOLE (DPM)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:NICOLE
Last Name:NOWICKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 SE 2ND ST APT 1720
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4477
Mailing Address - Country:US
Mailing Address - Phone:754-304-5091
Mailing Address - Fax:
Practice Address - Street 1:5405 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4543
Practice Address - Country:US
Practice Address - Phone:954-722-8080
Practice Address - Fax:954-722-4093
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4407213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery