MEDICARE: KATHERINE NOVAK-SELBY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	ARNP1568582	FL

General Provider Information

NPI Number	:	1295847614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE NOVAK-SELBY ARNP

Provider Business Mailing Address
First Line	:	2300 N COMMERCE PKWY
Second Line	:	SUITE 103
City	:	WESTON
State	:	FL
Zip	:	33326-3254
Country	:	US
Telephone Number	:	954-217-5700
Fax Number	:	954-217-5704

Provider Business Practice Location Address
First Line	:	2300 N COMMERCE PKWY
Second Line	:	SUITE 103
City	:	WESTON
State	:	FL
Zip	:	33326-3254
Country	:	US
Telephone Number	:	954-217-5700
Fax Number	:	954-217-5704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/25/2007

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