Healthcare Provider Details

I. General information

NPI: 1477468627
Provider Name (Legal Business Name): NOVARA COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 E SR 44 # 401A200
WILDWOOD FL
34785-7482
US

IV. Provider business mailing address

3990 E SR 44 # 401A200
WILDWOOD FL
34785-7482
US

V. Phone/Fax

Practice location:
  • Phone: 689-252-5537
  • Fax: 407-428-2102
Mailing address:
  • Phone: 689-252-5537
  • Fax: 407-428-2102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH E SANCHEZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 689-252-5537