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General NPI Number Information
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NPI Number | 1205920097
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Entity Type | Organization
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Legal Business Name | GABRIEL NOVOA JR MD PA
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 7101 SW 99TH AVE STE 109-A
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City | MIAMI
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State | FL
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Zip | 33173-4661
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Country | US
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Telephone | 305-596-4465
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Fax | 305-596-4495
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Provider Business Mailing Address
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Address Line | 7101 SW 99TH AVE STE 109-A
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City | MIAMI
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State | FL
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Zip | 33173-4661
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Country | US
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Telephone | 305-596-4465
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Fax | 305-596-4495
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PATRICIA CRISTINA NOVOA-VOGT
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Credential |
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Telephone | 305-596-4465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME83960
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME18212
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME039500
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License Number State | FL
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