MEDICARE: NOVOS BEHAVIORAL HEALTH CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	363LF0000X	Family Nurse Practitioner
3	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1811652795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVOS BEHAVIORAL HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	2103 CORAL WAY STE 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2656
Country	:	US
Telephone Number	:	786-464-0353
Fax Number	:	786-483-8142

Provider Business Practice Location Address
First Line	:	2103 CORAL WAY STE 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2656
Country	:	US
Telephone Number	:	786-464-0353
Fax Number	:	786-483-8142

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOSUE RODRIGUEZ
Credential	:	BA
Telephone Number	:	786-451-3040

Provider Enumeration Date	:	11/04/2021
Last Update Date	:	06/27/2023

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