Healthcare Provider Details

I. General information

NPI: 1003004276
Provider Name (Legal Business Name): VINCENZO NOVARA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NW 170TH ST SUITE 301
NORTH MIAMI BEACH FL
33169-5513
US

IV. Provider business mailing address

100 NW 170TH ST SUITE 301
NORTH MIAMI BEACH FL
33169-5513
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-3033
  • Fax: 305-655-1153
Mailing address:
  • Phone: 305-651-3033
  • Fax: 305-655-1153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENZO NOVARA
Title or Position: OWNER
Credential: MD
Phone: 786-295-6459