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NPI 1437967411

NPI 1437967411 : NOVALUNA MENTAL HEALTH LLC : WEST PALM BEACH, FL

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General NPI Number Information
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    NPI Number           |    1437967411
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    Entity Type          |    Organization 
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    Legal Business Name  |    NOVALUNA MENTAL HEALTH LLC 
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Dates
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    Enumeration Date     |    12/23/2024
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    Last Update Date     |    03/13/2025
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Provider Practice Location Address
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    Address Line         |    2000 PALM BEACH LAKES BLVD STE 303 
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    City                 |    WEST PALM BEACH
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    State                |    FL
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    Zip                  |    33409-6504
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    Country              |    US
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    Telephone            |    561-303-0811
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2000 PALM BEACH LAKES BLVD STE 303 
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    City                 |    WEST PALM BEACH
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    State                |    FL
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    Zip                  |    33409-6504
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    Country              |    US
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    Telephone            |    561-303-0811
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DAHIANA  RAFAILOVITC 
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    Credential           |    PMHNP
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    Telephone            |    561-800-8405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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