Organization Active NPI

Nova Rehabilitation, Inc

  • Occupational Therapist
  • Miami, FL
National Provider Identifier
1366401937
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NOVA REHABILITATION, INC
Practice address
10765 SW 104TH St
Miami, FL 33176-8164
Phone
(305) 979-9988
Fax
(844) 273-4740
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

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

Authorized official

Name
Mr. Carlos Guillermo Collado, MOT, R/L
Title
President
Phone
(305) 979-9988

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

10765 SW 104TH St
Miami, FL 33176-8164

Mailing address

10765 SW 104TH St
Miami, FL 33176-8164
Phone (305) 979-9988

Other identifiers 1

IdentifierTypeStateIssuer
886329600MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Nova Care Agency2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1366401937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 SW 104TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768164",
            "telephone_number": "305-979-9988",
            "fax_number": "844-273-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10765 SW 104TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768164",
            "telephone_number": "305-979-9988",
            "fax_number": "844-273-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "GUILLERMO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-979-9988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MOT, R/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886329600",
            "state": "FL"
        }
    ],
    "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 Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.