Organization Active NPI

Noval Medical Services, Corp

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1770827917
Registry record updated Nov 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9101023 Issued in FL
Legal business name
NOVAL MEDICAL SERVICES, CORP
Practice address
300 NW 86TH PL
Miami, FL 33126-3894
Phone
(305) 264-0124
NPI assigned
Nov 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Roberto A Nicodemo, PHYSICIAN ASSISTANT
Title
Director
Phone
(305) 264-0124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 9101023 FL Primary

Addresses

Primary practice location

300 NW 86TH PL
Miami, FL 33126-3894

Mailing address

300 NW 86TH PL
Miami, FL 33126-3894
Phone (305) 264-0124

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352592000000",
    "number": "1770827917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 86TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263894",
            "telephone_number": "305-264-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW 86TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263894",
            "telephone_number": "305-264-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAL MEDICAL SERVICES, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-11",
        "last_updated": "2012-11-11",
        "status": "A",
        "authorized_official_last_name": "NICODEMO",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "305-264-0124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9101023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.