Provider Demographics
NPI:1124012448
Name:NOVOA, ELIO RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIO
Middle Name:RAUL
Last Name:NOVOA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:875 MILITARY TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5700
Mailing Address - Country:US
Mailing Address - Phone:561-746-2411
Mailing Address - Fax:561-354-0012
Practice Address - Street 1:875 MILITARY TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5700
Practice Address - Country:US
Practice Address - Phone:561-746-2411
Practice Address - Fax:561-354-0012
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2024-01-18
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Provider Licenses
StateLicense IDTaxonomies
FLME43467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61383BMedicare PIN
FLD57218Medicare UPIN