| Nova Gastro Group LLC | |
|
8260 W Flagler St Ste 1a Miami FL 33144-2069 | |
| (786) 715-9183 | |
| (786) 715-9183 |
| Full Name | Nova Gastro Group LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 8260 W Flagler St Ste 1a, Miami, Florida |
| Authorized Official Name and Position | Ivan Dario Canas (CEO) |
| Authorized Official Contact | 7867159183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Gastro Group LLC 11420 N Kendall Dr Ste 207 Miami FL 33176-1039 Ph: (786) 715-9183 | Nova Gastro Group LLC 8260 W Flagler St Ste 1a Miami FL 33144-2069 Ph: (786) 715-9183 |
| NPI Number | 1124815196 |
|---|---|
| Provider Enumeration Date | 04/23/2025 |
| Last Update Date | 04/23/2025 |
| Certification Date | 04/23/2025 |
| Medicare PECOS PAC ID | 8729595251 |
|---|---|
| Medicare Enrollment ID | O20250729002230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124815196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Javier Sobrado |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689636391 PECOS PAC ID: 0143111674 Enrollment ID: I20040323001243 |
| Provider Name | Laura Costero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366871980 PECOS PAC ID: 0143446047 Enrollment ID: I20140730000992 |
| Provider Name | Osiel Nunez Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437693199 PECOS PAC ID: 8729465836 Enrollment ID: I20220511000802 |
| Provider Name | Yolanda Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841956091 PECOS PAC ID: 5597264515 Enrollment ID: I20250818001047 |
| Provider Name | Barbara B Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780415836 PECOS PAC ID: 8224533930 Enrollment ID: I20250924002327 |
| Provider Name | Ivan Pimienta Concepcion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134096399 PECOS PAC ID: 2668959008 Enrollment ID: I20260116000526 |
| Provider Name | Yusimi Gaspar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245717669 PECOS PAC ID: 8921590704 Enrollment ID: I20260116003341 |
| Provider Name | Yesenia Alonso Guerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275499477 PECOS PAC ID: 5294215257 Enrollment ID: I20260218000550 |
| Provider Name | Aura M Carrillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649081514 PECOS PAC ID: 9335622752 Enrollment ID: I20260313002548 |
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