Healthcare Provider Details

I. General information

NPI: 1962038380
Provider Name (Legal Business Name): ISABEL DE LA NOVAL GONZALEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 SW 8TH ST APT 1209
WEST MIAMI FL
33144-4863
US

IV. Provider business mailing address

6355 SW 8TH ST APT 1209
WEST MIAMI FL
33144-4863
US

V. Phone/Fax

Practice location:
  • Phone: 786-333-0479
  • Fax:
Mailing address:
  • Phone: 786-333-0479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11006538
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN11006538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: