Organization
NOVO PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE KIT SHADDIX MD (MANAGER)
(904) 316-1515
Entity
Organization
Contact information
Practice address
5147 N 9TH AVE, SUITE 203, PENSACOLA, FL 32504-8771
(904) 316-1515
Mailing address
5147 N 9TH AVE, SUITE 203, PENSACOLA, FL 32504-8771
(904) 316-1515
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME99596
FL
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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