| Nova Medical Services - Specialties Division Llc | |
|
8260 W Flagler St Ste 2i Miami FL 33144-2069 | |
| (786) 715-9183 | |
| (786) 713-1115 |
| Full Name | Nova Medical Services - Specialties Division Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8260 W Flagler St Ste 2i, Miami, Florida |
| Authorized Official Name and Position | Ivan Dario Canas (MGR) |
| Authorized Official Contact | 7867159183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Medical Services - Specialties Division Llc 8260 W Flagler St Ste 2i Miami FL 33144-2069 Ph: (786) 715-9183 | Nova Medical Services - Specialties Division Llc 8260 W Flagler St Ste 2i Miami FL 33144-2069 Ph: (786) 715-9183 |
| NPI Number | 1336722321 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 01/14/2023 |
| Certification Date | 01/14/2023 |
| Medicare PECOS PAC ID | 8729481643 |
|---|---|
| Medicare Enrollment ID | O20210729000314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336722321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Gregorio Caban |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205894391 PECOS PAC ID: 5496756611 Enrollment ID: I20070130000565 |
| Provider Name | Hernan Pabon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669683751 PECOS PAC ID: 2668556507 Enrollment ID: I20080301000013 |
| Provider Name | Oslaida Caballero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184188872 PECOS PAC ID: 7810329349 Enrollment ID: I20191121000216 |
| Provider Name | Suez Oramas Mingo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396237962 PECOS PAC ID: 6800296393 Enrollment ID: I20210622000120 |
| Provider Name | Katherine Blanco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013771229 PECOS PAC ID: 8628412517 Enrollment ID: I20240219003730 |
| Provider Name | Yehan Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881448520 PECOS PAC ID: 5092155051 Enrollment ID: I20240424004175 |
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