Provider Demographics
NPI:1730384348
Name:NOVAK & NOVAK PA
Entity type:Organization
Organization Name:NOVAK & NOVAK PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-837-0141
Mailing Address - Street 1:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32540-0907
Mailing Address - Country:US
Mailing Address - Phone:850-837-7777
Mailing Address - Fax:850-837-8801
Practice Address - Street 1:994 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2820
Practice Address - Country:US
Practice Address - Phone:850-837-7777
Practice Address - Fax:850-837-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47875174400000X
FLME47513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty