Provider Demographics
NPI:1952853988
Name:NOVA REHABILITATION INC.
Entity Type:Organization
Organization Name:NOVA REHABILITATION INC.
Other - Org Name:NOVA CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:GUILLERMO
Authorized Official - Last Name:COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:MOT
Authorized Official - Phone:305-979-9988
Mailing Address - Street 1:10765 SW 104TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8164
Mailing Address - Country:US
Mailing Address - Phone:305-979-9988
Mailing Address - Fax:
Practice Address - Street 1:10765 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8164
Practice Address - Country:US
Practice Address - Phone:305-979-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health