Provider Demographics
NPI:1598159923
Name:NOVA-CARE REHAB SERVICES, INC
Entity Type:Organization
Organization Name:NOVA-CARE REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YURIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-888-6222
Mailing Address - Street 1:PO BOX 262435
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-2435
Mailing Address - Country:US
Mailing Address - Phone:813-888-6222
Mailing Address - Fax:813-888-6333
Practice Address - Street 1:6301 MEMORIAL HWY
Practice Address - Street 2:SUITE 304
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4573
Practice Address - Country:US
Practice Address - Phone:813-888-6222
Practice Address - Fax:813-888-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9428261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC9428OtherAHCA