NPIMap

Organization Active NPI

Nova Medical Services - Dermatology Division LLC

  • Dermatology Physician
  • Miami, FL
National Provider Identifier
1861137655
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NOVA MEDICAL SERVICES - DERMATOLOGY DIVISION LLC
Practice address
8260 W Flagler St Ste 2I
Miami, FL 33144-2069
Phone
(786) 715-9183
Fax
(786) 713-1115
NPI assigned
May 5, 2022
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Dr. Ivan Dario Canas Jr., DNPNPI 1366066649
Title
Ceo
Phone
(786) 715-9183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

8260 W Flagler St Ste 2I
Miami, FL 33144-2069

Mailing address

8260 W Flagler St Ste 2I
Miami, FL 33144-2069
Phone (786) 715-9183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220707000068 FL Part B Supplier - Clinic/Group Practice 1850771916 Receives reassigned benefits from 20 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8269 W Flagler St Ste 2I
Miami, FL 33144

8270 W Flagler St Ste 2I
Miami, FL 33144

8272 W Flagler St Ste 2I
Miami, FL 33144

8273 W Flagler St Ste 2I
Miami, FL 33144

8281 W Flagler St Ste 2I
Miami, FL 33144

8260 W Flagler St
West Miami, FL 33144
Phone (305) 226-4775

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1861137655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 W FLAGLER ST STE 2I",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442069",
            "telephone_number": "786-715-9183",
            "fax_number": "786-713-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 W FLAGLER ST STE 2I",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442069",
            "telephone_number": "786-715-9183",
            "fax_number": "786-713-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA MEDICAL SERVICES - DERMATOLOGY DIVISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "CANAS",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "DARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-715-9183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 May 5, 2022; 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.