MEDICARE: DR. ALFREDO NOVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME0084728	FL
2	207VG0400X	Gynecology Physician	ME0084728	FL
3	207VX0000X	Obstetrics Physician	ME0084728	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	E8554Y	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7811	OTHER	FL	BLUE CROSS PROVIDER NO
3	200339927	OTHER	FL	COMMERCIAL BILLING
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790894871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDO NOVA M.D.

Provider Business Mailing Address
First Line	:	1634 N PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5323
Country	:	US
Telephone Number	:	850-942-7750
Fax Number	:	850-942-7414

Provider Business Practice Location Address
First Line	:	1634 N PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5323
Country	:	US
Telephone Number	:	850-942-7750
Fax Number	:	850-942-7414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. ALFREDO NOVA M.D.” Practice Location

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