Healthcare Provider Details

I. General information

NPI: 1245149798
Provider Name (Legal Business Name): NICOLE L BILKIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S PINE ISLAND RD STE 204
PLANTATION FL
33324-4413
US

IV. Provider business mailing address

4821 NW 58TH MNR
COCONUT CREEK FL
33073-2312
US

V. Phone/Fax

Practice location:
  • Phone: 866-243-9104
  • Fax:
Mailing address:
  • Phone: 609-571-6467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: