Healthcare Provider Details

I. General information

NPI: 1417514985
Provider Name (Legal Business Name): NOVEL HEALTH CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14134 NEPHRON LN
HUDSON FL
34667-6504
US

IV. Provider business mailing address

14134 NEPHRON LN
HUDSON FL
34667-6504
US

V. Phone/Fax

Practice location:
  • Phone: 727-863-5418
  • Fax: 727-497-0028
Mailing address:
  • Phone: 727-863-5418
  • Fax: 727-497-0028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MURALIDHAR K ACHARYA
Title or Position: SOLE MEMBER
Credential: MD
Phone: 727-863-5418