# NIRVANA CLINIC CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396441689
- **Authorized official:** DANIELA MANNO (CFO)
- **Authorized official phone:** (786) 577-0024

## Contact information

- **Practice address:** 8765 SW 165TH AVE STE 105, MIAMI, FL 33193-5832
- **Practice address phone:** (786) 577-0024
- **Practice address fax:** (786) 773-2234
- **Mailing address:** 8765 SW 165TH AVE STE 105, MIAMI, FL 33193-5832
- **Mailing address phone:** (786) 577-0024
- **Mailing address fax:** (786) 773-2234

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | NULL | Yes |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2023
- **Last updated:** 02/07/2023