Provider Demographics
NPI:1588440903
Name:NOVA, GLEYDY JOSFINA (BA)
Entity type:Individual
Prefix:
First Name:GLEYDY
Middle Name:JOSFINA
Last Name:NOVA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:GLEYDY
Other - Middle Name:JOSEFINA
Other - Last Name:NOVAS ANGELES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:7903 SEMINOLE BLVD APT 2105
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4830
Mailing Address - Country:US
Mailing Address - Phone:813-447-7284
Mailing Address - Fax:
Practice Address - Street 1:602 VONDERBURG DR STE 201
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5900
Practice Address - Country:US
Practice Address - Phone:813-653-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI61802355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant