Provider Demographics
NPI:1760815674
Name:NOVAS, VICTOR
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:NOVAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 W FLAGLER ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1446
Mailing Address - Country:US
Mailing Address - Phone:305-446-9923
Mailing Address - Fax:305-446-9924
Practice Address - Street 1:4800 W FLAGLER ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1446
Practice Address - Country:US
Practice Address - Phone:305-446-9923
Practice Address - Fax:305-446-9924
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
461855595170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics