Healthcare Provider Details

I. General information

NPI: 1124626494
Provider Name (Legal Business Name): NOVA HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9260 SUNSET DR STE 220
MIAMI FL
33173-3275
US

IV. Provider business mailing address

9260 SUNSET DR STE 220
MIAMI FL
33173-3275
US

V. Phone/Fax

Practice location:
  • Phone: 786-254-7107
  • Fax: 786-502-8895
Mailing address:
  • Phone: 786-254-7107
  • Fax: 786-502-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SONIA HURTADO
Title or Position: PRESIDENT
Credential:
Phone: 786-498-9678