Healthcare Provider Details

I. General information

NPI: 1245197565
Provider Name (Legal Business Name): NOVA LEARNING AND DEVELOPMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ROBERT J CONLAN BLVD NE STE 120-6
PALM BAY FL
32905-3502
US

IV. Provider business mailing address

1501 ROBERT J CONLAN BLVD NE STE 120-6
PALM BAY FL
32905-3502
US

V. Phone/Fax

Practice location:
  • Phone: 786-378-2053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JOSE LADRON DE GUEVARA
Title or Position: OWNER
Credential:
Phone: 786-378-2053