MEDICARE: NOVA LEARNING AND DEVELOPMENT GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1245197565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA LEARNING AND DEVELOPMENT GROUP LLC

Provider Business Mailing Address
First Line	:	1501 ROBERT J CONLAN BLVD NE STE 120-6
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-3502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 ROBERT J CONLAN BLVD NE STE 120-6
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-3502
Country	:	US
Telephone Number	:	786-378-2053
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSE LADRON DE GUEVARA
Credential	:
Telephone Number	:	786-378-2053

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “NOVA LEARNING AND DEVELOPMENT GROUP LLC ” Practice Location

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