MEDICARE: NINOUCHEKA ORLEANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11026615	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1117	OTHER	NJ	1013
2	1117	OTHER	NJ	1117

General Provider Information

NPI Number	:	1588245245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINOUCHEKA ORLEANS

Provider Business Mailing Address
First Line	:	1911 HARRISON ST STE 2
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-5017
Country	:	US
Telephone Number	:	786-883-0010
Fax Number	:	786-883-0013

Provider Business Practice Location Address
First Line	:	1911 HARRISON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-5017
Country	:	US
Telephone Number	:	786-883-0010
Fax Number	:	786-880-0013

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2021
Last Update Date	:	07/24/2024

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Directions to “ NINOUCHEKA ORLEANS ” Practice Location

Language	Start Address	Practice Location

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