Healthcare Provider Details

I. General information

NPI: 1841004371
Provider Name (Legal Business Name): NOVA MEDICAL SERVICES - RESEARCH DIVISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11440 N KENDALL DR STE 111
MIAMI FL
33176-1024
US

IV. Provider business mailing address

11420 N KENDALL DR STE 206
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 Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

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