Healthcare Provider Details

I. General information

NPI: 1578145793
Provider Name (Legal Business Name): NOVA MEDICAL SERVICES - WOUND CARE DIVISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 09/02/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11420 N KENDALL DR STE 207
MIAMI FL
33176-1039
US

IV. Provider business mailing address

11420 N KENDALL DR STE 207
MIAMI FL
33176-1039
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-9183
  • Fax: 786-713-1115
Mailing address:
  • Phone: 786-715-9183
  • Fax: 786-713-1115

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: DR. IVAN DARIO CANAS JR.
Title or Position: CEO
Credential: DNP
Phone: 786-715-9183