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General NPI Number Information
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NPI Number | 1952853988
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Entity Type | Organization
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Legal Business Name | NOVA REHABILITATION INC.
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 10765 SW 104TH ST
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City | MIAMI
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State | FL
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Zip | 33176-8164
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Country | US
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Telephone | 305-979-9988
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Fax |
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Provider Business Mailing Address
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Address Line | 10765 SW 104TH ST
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City | MIAMI
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State | FL
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Zip | 33176-8164
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Country | US
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Telephone | 305-979-9988
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. CARLOS GUILLERMO COLLADO
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Credential | MOT
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Telephone | 305-979-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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