Provider Demographics
NPI:1295431468
Name:NOVA WELLNESS CENTER
Entity type:Organization
Organization Name:NOVA WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-709-1918
Mailing Address - Street 1:5300 W HILLSBORO BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4395
Mailing Address - Country:US
Mailing Address - Phone:954-614-4053
Mailing Address - Fax:954-531-1342
Practice Address - Street 1:5300 W HILLSBORO BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:954-614-4053
Practice Address - Fax:954-531-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care