MEDICARE: MS. NICOLE RENEE OVEDIA LCSW

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	1041C0700X	Clinical Social Worker	4791	FL

General Provider Information

NPI Number	:	1700454105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE RENEE OVEDIA LCSW

Provider Business Mailing Address
First Line	:	936 KOKOMO KEY LN
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-6031
Country	:	US
Telephone Number	:	561-762-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 KOKOMO KEY LN FL 33483
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-6031
Country	:	US
Telephone Number	:	561-762-0027
Fax Number	:	954-212-5757

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

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	12/02/2025

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