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General NPI Number Information
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NPI Number | 1548863038
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Entity Type | Organization
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Legal Business Name | NOVEM DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 17653 N DALE MABRY HWY
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City | LUTZ
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State | FL
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Zip | 33548-4535
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Country | US
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Telephone | 813-590-2120
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Fax | 813-590-2125
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Provider Business Mailing Address
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Address Line | 17653 N DALE MABRY HWY
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City | LUTZ
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State | FL
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Zip | 33548-4535
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Country | US
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Telephone | 813-590-2120
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Fax | 813-590-2125
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | NICOLE MARIE HOWE
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Credential | MD
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Telephone | 813-927-1915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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