Individual provider Active NPI

Mabel Gonzalez Novo, M.D.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1285643486
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME100923 Issued in FL
Practice address
5111 N Armenia Ave
Tampa, FL 33603-1405
Phone
(813) 272-0420
Fax
(844) 388-6186
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME100923 FL Primary

Addresses

Primary practice location

5111 N Armenia Ave
Tampa, FL 33603-1405

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Other identifiers 1

IdentifierTypeStateIssuer
ME 100923OtherFLMEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000207 FL Practitioner - Family Practice 6305848946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Medical Associates LLCGroup PAC ID 0648271155, 162 clinicians

Practice addresses (Care Compare)

13940 N US Hwy 441
Suite 102
Lady Lake, FL 32159-8909
Phone (352) 751-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME100923FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Associates LLC CurrentSince Mar 1, 2023 Accepting new patients
McKinnon Rheumatology Associates PLLC CurrentSince Feb 25, 2024 Accepting new patients

Locations

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

5111 N Armenia Ave
Tampa, FL 33603
Phone (813) 272-0420

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

7575 W Washington Ave
#127160
Las Vegas, NV 89128

2400 S Cimarron Rd
Ste 120
Las Vegas, NV 89117
Phone (702) 505-4230

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mabel.gonzaleznovo@sl.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1285643486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031405",
            "telephone_number": "813-272-0420",
            "fax_number": "844-388-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ NOVO",
        "first_name": "MABEL",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-01-31",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME100923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "ME 100923",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.