Provider Demographics
NPI:1750797478
Name:BOSKOVSKI, NIKOLA (MD)
Entity type:Individual
Prefix:
First Name:NIKOLA
Middle Name:
Last Name:BOSKOVSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 ARTHUR GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3413
Mailing Address - Country:US
Mailing Address - Phone:305-552-9102
Mailing Address - Fax:305-552-5957
Practice Address - Street 1:757 ARTHUR GODFREY RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3413
Practice Address - Country:US
Practice Address - Phone:305-552-9102
Practice Address - Fax:305-552-5957
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50634207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME50634OtherMEDICAL LICENSE