Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME150853 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME150853 | FL |
NPI | 1013355999 |
---|---|
Provider Name | Dr. Italo Carlos Novoa Reyes |
First Address | Boca Raton, FL 33431-4531 |
Second Address | Stuart, FL 34996-2576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 13/07/2021 |