Healthcare Provider Details
I. General information
NPI: 1043563257
Provider Name (Legal Business Name): INOVA HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2012
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8348 TRAFORD LN STE 100
SPRINGFIELD VA
22152-1650
US
IV. Provider business mailing address
8095 INNOVATION PARK DR BLDG D
FAIRFAX VA
22031-4868
US
V. Phone/Fax
- Phone: 703-569-7335
- Fax: 703-569-0665
- Phone: 703-881-1895
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224Z00000X |
| Taxonomy | Occupational Therapy Assistant |
| License Number | |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | VA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | VA |
VIII. Authorized Official
Name:
RICARDO
TALENTO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 571-472-8717