Provider Demographics
NPI:1235331125
Name:NOVIS, NORMAN S (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:S
Last Name:NOVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-0658
Mailing Address - Country:US
Mailing Address - Phone:352-633-7649
Mailing Address - Fax:352-633-7694
Practice Address - Street 1:801 HIGHWAY 466
Practice Address - Street 2:SUITE B101
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3925
Practice Address - Country:US
Practice Address - Phone:352-633-7649
Practice Address - Fax:352-633-7694
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME98440207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279767400Medicaid
FL78309OtherBCBS OF FL
FL78309OtherBCBS OF FL