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General NPI Number Information
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NPI Number | 1720107246
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Entity Type | Organization
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Legal Business Name | ROBERTO NOVOA, M.D., LLC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 2600 6TH ST SW BUILDING A, STE A2-110
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City | CANTON
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State | OH
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Zip | 44710-1702
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Country | US
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Telephone | 330-363-1341
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Fax | 330-363-0074
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Provider Business Mailing Address
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Address Line | 2600 SIXTH STREET SW SUITE A2-110
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City | CANTON
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State | OH
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Zip | 44706-0329
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Country | US
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Telephone | 330-363-1341
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Fax | 330-363-0074
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ROBERTO NOVOA
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Credential | MD
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Telephone | 330-363-1341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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