Provider Demographics
NPI:1346427671
Name:NOVAK-MCCAFFERTY, MARY E (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:NOVAK-MCCAFFERTY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1074
Mailing Address - Country:US
Mailing Address - Phone:940-239-0319
Mailing Address - Fax:
Practice Address - Street 1:12100 SW 127TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4663
Practice Address - Country:US
Practice Address - Phone:305-969-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9263822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily