Healthcare Provider Details

I. General information

NPI: 1861921223
Provider Name (Legal Business Name): KAREN BOVA FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 SEMINOLA BLVD
CASSELBERRY FL
32707-3057
US

IV. Provider business mailing address

661 SEMINOLA BLVD
CASSELBERRY FL
32707-3057
US

V. Phone/Fax

Practice location:
  • Phone: 689-248-5317
  • Fax:
Mailing address:
  • Phone: 689-248-5317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number290453
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3407562
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number290453
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3407562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: