Healthcare Provider Details

I. General information

NPI: 1154298560
Provider Name (Legal Business Name): VIRGINIA J NODA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 N DIXIE HWY
OAKLAND PARK FL
33334-4135
US

IV. Provider business mailing address

1601 NW 58TH AVE
MARGATE FL
33063-2807
US

V. Phone/Fax

Practice location:
  • Phone: 954-734-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11042711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: