Healthcare Provider Details

I. General information

NPI: 1386203131
Provider Name (Legal Business Name): DANIELLE CHERRNAY NOVICK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE
FORT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

10642 ZURICH ST
HOLLYWOOD FL
33026-4831
US

V. Phone/Fax

Practice location:
  • Phone: 954-249-5500
  • Fax:
Mailing address:
  • Phone: 954-249-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11002940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: