Provider Demographics
NPI:1780223818
Name:NOVOA, HERMES (DNP, CRNA, APRN)
Entity Type:Individual
Prefix:DR
First Name:HERMES
Middle Name:
Last Name:NOVOA
Suffix:
Gender:M
Credentials:DNP, CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 SW 143RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7006
Mailing Address - Country:US
Mailing Address - Phone:786-738-1410
Mailing Address - Fax:
Practice Address - Street 1:11001 SW 143RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7006
Practice Address - Country:US
Practice Address - Phone:786-738-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9320977163W00000X
FLAPRN11005952367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9320977OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH: RN LICENSE
FLAPRN11005952OtherAPRN LICENSE