Organization Active NPI

Novavita Med Center LLC

  • Clinic/Center
  • Miami, FL
National Provider Identifier
1194563379
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NOVAVITA MED CENTER LLC
Practice address
13501 SW 136TH St Ste 208
Miami, FL 33186-8321
Phone
(305) 284-7574
NPI assigned
Jul 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maria Ursula Hernandez Moran, NPNPI 1467087577
Title
President
Phone
(305) 562-0802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

13501 SW 136TH St Ste 208
Miami, FL 33186-8321

Mailing address

13501 SW 136TH St Ste 208
Miami, FL 33186-8321
Phone (305) 284-7574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240827001214 FL Part B Supplier - Clinic/Group Practice 5496294142 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

13501 SW 136th St
Ste 208
Miami, FL 33186
Phone (305) 284-7574

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1194563379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 SW 136TH ST STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868321",
            "telephone_number": "305-284-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 SW 136TH ST STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868321",
            "telephone_number": "305-284-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAVITA MED CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ MORAN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "URSULA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-562-0802",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.