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General NPI Number Information
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NPI Number | 1972393064
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Entity Type | Organization
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Legal Business Name | MLNN LIBELULLA, LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 6732 GREYWALLS LN
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City | RALEIGH
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State | NC
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Zip | 27614-8206
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Country | US
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Telephone | 305-510-0526
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Fax |
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Provider Business Mailing Address
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Address Line | 3640 18TH AVE NE
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City | NAPLES
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State | FL
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Zip | 34120-5534
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Country | US
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Telephone | 305-510-0526
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARLENIS L HERNANDEZ NOVOA
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Credential |
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Telephone | 305-510-0526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number |
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License Number State |
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