| Organization Name: | INNOVA MEDICAL PLLC |
| NPI Number: | 1194066472 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY ANTHONY MICELI (PRESIDENT) |
| Mailing Address: | 740 Cool Springs Blvd Suite 120 Franklin |
| State: | TN US |
| Postal Code: | 370676448 |
| Phone Number: | 6155506097 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2013 |
| NPI Last Update Date: | 03/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD31405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |