1. Home
  2. Directory
  3. Florida
  4. Jacksonville
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NIKOL FEDOTOVA
NPI 1477495737
Student in an Organized Health Care Education/Training Program in Jacksonville, FL

Active since April 07, 2026
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204(904) 308-7372 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 17, 2026, Apr 7, 2026 (2 updates tracked since 2026).

About Nikol Fedotova NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIKOL FEDOTOVA (NPI 1477495737) is an individual student in an organized health care education/training program in Jacksonville, Florida, licensed in Florida (UO11456) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1477495737
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameNIKOL FEDOTOVA
Location Address2627 RIVERSIDE AVEJacksonville, FL 32204-4717
Mailing Address2627 Riverside AveJacksonville, FL 32204-4717 · (904) 308-7372
Phone(904) 308-7372
Sole ProprietorYes
Enumeration DateApril 7, 2026
Last NPPES UpdateAugust 17, 20262 updates tracked since enumeration
NPPES CertifiedAugust 17, 2026
✔ NPI 1477495737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in FL · UO11456
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2627 RIVERSIDE AVE, Jacksonville, FL 32204
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Physical Therapist
2627 RIVERSIDE AVE, 3RD FLOOR
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
DR. HANAIN FAZAL DO
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
YVONNE NYAKIO KAMAU MD
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
DANIEL B TEAHAN PT
Physical Therapist
2627 RIVERSIDE AVE, SUITE 300
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
MRS. SONYA JEAN DOMINGUEZ M.D.
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
KRISTEN M. CURTIS PT
Physical Therapist (Orthopedic)
2627 RIVERSIDE AVE, SUITE 300
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
FARADIA PIERRE MD
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
JOHN W WAIDNER M.D.
Pediatrics
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikol Fedotova's NPI number?

The NPI number for Nikol Fedotova is 1477495737. It was assigned to this individual provider in the NPPES registry on April 7, 2026.

Where is Nikol Fedotova located?

Nikol Fedotova practices at 2627 Riverside Ave, Jacksonville, FL 32204. The listed phone number is (904) 308-7372.

What is Nikol Fedotova's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Nikol Fedotova was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.