Provider Demographics
NPI:1619012853
Name:NOVIA, VITO LUKE (LMT)
Entity Type:Individual
Prefix:MR
First Name:VITO
Middle Name:LUKE
Last Name:NOVIA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1813 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8597
Mailing Address - Country:US
Mailing Address - Phone:407-359-2757
Mailing Address - Fax:407-359-7464
Practice Address - Street 1:1020 LOCKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6027
Practice Address - Country:US
Practice Address - Phone:407-359-2757
Practice Address - Fax:407-359-7464
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA36301225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist