Provider Demographics
NPI:1194778175
Name:NENOV, NEVIANA IORDANOVA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:NEVIANA
Middle Name:IORDANOVA
Last Name:NENOV
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 WEST CAMINO REAL
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433
Mailing Address - Country:US
Mailing Address - Phone:561-368-8998
Mailing Address - Fax:561-392-9170
Practice Address - Street 1:7200 WEST CAMINO REAL
Practice Address - Street 2:SUITE 215
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:561-368-8998
Practice Address - Fax:561-392-9170
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME888352084P0800X
MA2139142084P0800X
LAMD.0258992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA35059OtherPROVIDER #
FLU4107ZOtherSUPPLIER NUMBER
FLA35059OtherPROVIDER #