# NOVU DERMATOLOGY & INTERNAL MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700398096
- **Authorized official:** MIGDALIA SANES (CREDENTIALING MANAGER)
- **Authorized official phone:** (352) 427-3882

## Contact information

- **Practice address:** 929 N US HIGHWAY 441 STE 603, LADY LAKE, FL 32159-3003
- **Practice address phone:** (407) 216-3888
- **Mailing address:** PO BOX 2420, WINDERMERE, FL 34786-2420
- **Mailing address phone:** (352) 775-3565
- **Mailing address fax:** (352) 633-3704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/26/2017
- **Last updated:** 10/04/2021