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Organization

PHCA ADMINISTRATION,LLC

Active
Parent organization
NOVELLE HEALTH, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NOVELLE HEALTH, LLC
Authorized official
DEBRA S GONZALEZ (PHCA ADMINISTRATION, LLC, C.O.O.)
(813) 854-2003
Entity
Organization

Contact information

Practice address
4033 TAMPA RD, SUITE 101, OLDSMAR, FL 34677-3224
(813) 854-2003
(813) 855-2367
Mailing address
4033 TAMPA RD, SUITE 101, OLDSMAR, FL 34677-3224
(813) 854-2003
(813) 855-2367

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
04/06/2017
Last updated
04/06/2017
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