| Nova Community Services Corp | |
|
9867 Sw 184th St Palmetto Bay FL 33157-6934 | |
| (786) 732-2287 | |
| (786) 732-2288 |
| Full Name | Nova Community Services Corp |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9867 Sw 184th St, Palmetto Bay, Florida |
| Authorized Official Name and Position | Beatriz Caridad Diaz Gonzalez (PRESIDENT) |
| Authorized Official Contact | 7867322287 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Community Services Corp 9867 Sw 184th St Palmetto Bay FL 33157-6934 Ph: () - | Nova Community Services Corp 9867 Sw 184th St Palmetto Bay FL 33157-6934 Ph: (786) 732-2287 |
| NPI Number | 1861089054 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Medicare PECOS PAC ID | 0648679720 |
|---|---|
| Medicare Enrollment ID | O20210521000815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861089054 | NPI | - | NPPES |
| 115831500 | Medicaid | FL | |
| 116151000 | Medicaid | FL |
| Provider Name | Manuel M Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740226190 PECOS PAC ID: 0042271991 Enrollment ID: I20041023000066 |
| Provider Name | Oricel Aguiar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942624036 PECOS PAC ID: 9537486139 Enrollment ID: I20150319000478 |
| Provider Name | Jany Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841735636 PECOS PAC ID: 0840554549 Enrollment ID: I20180504001053 |
| Provider Name | Yanel Llanes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124618103 PECOS PAC ID: 0648668608 Enrollment ID: I20211023000160 |
| Provider Name | Josue Lopez |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1215469499 PECOS PAC ID: 2163811944 Enrollment ID: I20211117000302 |
| Provider Name | Michelle M Lebron Ginorio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932762705 PECOS PAC ID: 0648627182 Enrollment ID: I20231106001936 |
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