MEDICARE: NOVA RHEUMATOLOGY GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1538094545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA RHEUMATOLOGY GROUP LLC

Provider Business Mailing Address
First Line	:	11420 N KENDALL DR STE 207
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1039
Country	:	US
Telephone Number	:	786-715-9183
Fax Number	:	786-713-1115

Provider Business Practice Location Address
First Line	:	8260 W FLAGLER ST STE 2I
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2069
Country	:	US
Telephone Number	:	786-715-9183
Fax Number	:	786-713-1115

Authorized Official
Title or Position	:	CEO
Name	:	DR. IVAN DARIO CANAS JR.
Credential	:	DNP, MBA
Telephone Number	:	786-715-9183

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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