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General NPI Number Information
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NPI Number | 1780837708
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Entity Type | Individual
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Provider Name | JAMIE DANIEL NOVAK CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 4725 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-771-8000
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Fax | 954-351-4727
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Provider Business Mailing Address
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Address Line | PO BOX 80690
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City | CANTON
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State | OH
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Zip | 44708-0690
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Country | US
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Telephone | 330-833-5530
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Fax | 330-833-6085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA10359NA
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License Number State | OH
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