Healthcare Provider Details

I. General information

NPI: 1437089299
Provider Name (Legal Business Name): NOVACARE MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 IVES DAIRY RD STE 131
MIAMI FL
33179-2538
US

IV. Provider business mailing address

1031 IVES DAIRY RD STE 131
MIAMI FL
33179-2538
US

V. Phone/Fax

Practice location:
  • Phone: 305-942-3294
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KARIN FABRA GOMEZ
Title or Position: CEO
Credential:
Phone: 305-942-3294