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General NPI Number Information
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NPI Number | 1376515510
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Entity Type | Individual
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Provider Name | MARCO A NOVA MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 6043 NW 167TH STREET SUITE # A1
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City | MIAMI
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State | FL
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Zip | 33015-4326
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Country | US
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Telephone | 305-821-8282
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Fax | 305-824-3233
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Provider Business Mailing Address
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Address Line | 6043 NW 167TH STREET SUITE # A 1
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City | MIAMI
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State | FL
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Zip | 33015-4326
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Country | US
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Telephone | 305-821-8282
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Fax | 305-824-3233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME87202
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License Number State | FL
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