Provider Demographics
NPI:1649741034
Name:NOVAL, ELIZABET (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABET
Middle Name:
Last Name:NOVAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15614 SW 25TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5769
Mailing Address - Country:US
Mailing Address - Phone:786-334-1724
Mailing Address - Fax:
Practice Address - Street 1:15614 SW 25TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5769
Practice Address - Country:US
Practice Address - Phone:786-334-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF12180109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily