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General NPI Number Information
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NPI Number | 1316290042
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Entity Type | Organization
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Legal Business Name | NORMAN S NOVIS MD PA
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 753 HIGHWAY 466
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City | LADY LAKE
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State | FL
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Zip | 32159-6340
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Country | US
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Telephone | 352-633-7649
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-0658
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Country | US
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Telephone | 352-633-7649
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NORMAN S NOVIS
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Credential | MD
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Telephone | 352-633-7649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME98440
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License Number State | FL
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