Healthcare Provider Details

I. General information

NPI: 1699692103
Provider Name (Legal Business Name): DANIEL NOVOA LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6570 GRIFFIN RD
DAVIE FL
33314-4391
US

IV. Provider business mailing address

4854 BLISTERING WAY
LAKE WORTH FL
33467-6701
US

V. Phone/Fax

Practice location:
  • Phone: 954-488-3388
  • Fax:
Mailing address:
  • Phone: 954-980-7988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: