Provider Demographics
NPI:1003829227
Name:NOVA ORTHOPEDIC CLINIC INC
Entity Type:Organization
Organization Name:NOVA ORTHOPEDIC CLINIC INC
Other - Org Name:QUIRANTES ORTHOPEDIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEYVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-545-7777
Mailing Address - Street 1:1420 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2203
Mailing Address - Country:US
Mailing Address - Phone:305-545-7777
Mailing Address - Fax:305-545-8163
Practice Address - Street 1:1420 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2203
Practice Address - Country:US
Practice Address - Phone:305-545-7777
Practice Address - Fax:305-545-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0130930001Medicare NSC