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General NPI Number Information
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NPI Number | 1487596672
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Entity Type | Organization
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Legal Business Name | INNOVA PHYSICIANS NETWORK LLC
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 5881 NW 151ST ST STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2442
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Country | US
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Telephone | 786-320-3460
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Fax | 305-203-0729
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Provider Business Mailing Address
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Address Line | 10280 NW 46TH ST
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City | DORAL
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State | FL
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Zip | 33178-2258
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Country | US
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Telephone | 786-320-3460
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Fax | 305-203-0729
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. FABIOLA FERNANDEZ
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Credential |
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Telephone | 786-320-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RI0001X
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Taxonomy Name | Clinical & Laboratory Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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