Provider Demographics
NPI:1972393064
Name:MLNN LIBELULLA, LLC
Entity type:Organization
Organization Name:MLNN LIBELULLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERNANDEZ NOVOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-510-0526
Mailing Address - Street 1:3640 18TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5534
Mailing Address - Country:US
Mailing Address - Phone:305-510-0526
Mailing Address - Fax:
Practice Address - Street 1:6732 GREYWALLS LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8206
Practice Address - Country:US
Practice Address - Phone:305-510-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No347C00000XTransportation ServicesPrivate Vehicle
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health