Provider Demographics
NPI:1962038380
Name:DE LA NOVAL GONZALEZ, ISABEL (ARNP)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:DE LA NOVAL GONZALEZ
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 1:6355 SW 8TH ST APT 1209
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4863
Mailing Address - Country:US
Mailing Address - Phone:786-333-0479
Mailing Address - Fax:
Practice Address - Street 1:6355 SW 8TH ST APT 1209
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4863
Practice Address - Country:US
Practice Address - Phone:786-333-0479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006538363LF0000X
FLAPRN11006538363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily