=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043563257
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INOVA HEALTH CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2012
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8348 TRAFORD LN STE 100
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22152-1650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-569-7335
-----------------------------------------------------
Fax | 703-569-0665
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8095 INNOVATION PARK DR BLDG D
-----------------------------------------------------
City | FAIRFAX
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22031-4868
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-881-1895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | RICARDO TALENTO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 571-472-8717
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------