Organization
NOVAVITA MED CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA URSULA HERNANDEZ MORAN NP (PRESIDENT)
(305) 562-0802
Entity
Organization
Contact information
Practice address
13501 SW 136TH ST STE 208, MIAMI, FL 33186-8321
(305) 284-7574
Mailing address
13501 SW 136TH ST STE 208, MIAMI, FL 33186-8321
(305) 284-7574
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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