Provider Demographics
NPI:1699750455
Name:NOVAK, JOHN STEVEN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STEVEN
Last Name:NOVAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1471
Mailing Address - Country:US
Mailing Address - Phone:904-296-4299
Mailing Address - Fax:904-296-4399
Practice Address - Street 1:4205 BELFORT RD
Practice Address - Street 2:SUITE 1003
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1471
Practice Address - Country:US
Practice Address - Phone:904-296-4299
Practice Address - Fax:904-296-4399
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 31320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist