Provider Demographics
NPI:1649625930
Name:NOVA AETAS GROUP INC.
Entity type:Organization
Organization Name:NOVA AETAS GROUP INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAGOBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTEX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-352-9013
Mailing Address - Street 1:11098 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7429
Mailing Address - Country:US
Mailing Address - Phone:786-352-9013
Mailing Address - Fax:
Practice Address - Street 1:11098 BISCAYNE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-7429
Practice Address - Country:US
Practice Address - Phone:786-352-9013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care