Nicole Maksutovic, PHARMD
Individual provider Active NPI Pharmacist · West Palm Beach, FL
NPI 1386249381 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1386249381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS60860 (FL)
- Practice address
- 1301 N Dixie Hwy
West Palm Beach, FL 33401-2703 - Phone
- (561) 366-1125
- Fax
- (561) 366-3609
- NPI assigned
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS60860 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past |
Accepting new patients | |
| Holiday CVS LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS60860 | FL | Yes |
Addresses
Primary practice location
1301 N Dixie Hwy
West Palm Beach, FL 33401-2703
Mailing address
1301 N Dixie Hwy
West Palm Beach, FL 33401-2703
Phone (561) 366-1125
Other providers in West Palm Beach, FL
- Crystal Jade Major Bryan
- Tamika Major
- Alia Makboul
- Oluwafemi Makinde
- Anthony Henry Makins
- Aydermis Malagon Ramos
- Ashalee Malary
- Robin K Malasky
- Joseph Dean Malaterra
- Evelyn Malave
All providers in West Palm Beach, FL · Pharmacist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.