Healthcare Provider Details

I. General information

NPI: 1750214904
Provider Name (Legal Business Name): NOVALANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11009 LAKEWOOD POINTE DR APT 104
SEFFNER FL
33584-4331
US

IV. Provider business mailing address

10012 PALERMO CIR APT 301
TAMPA FL
33619-5037
US

V. Phone/Fax

Practice location:
  • Phone: 813-486-9792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JENLANA LARRY
Title or Position: OWNER
Credential:
Phone: 813-486-9792