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Organization
NOVA SOUTHEASTERN UNIVERSITY, INC
Active
Organization
NOVA SOUTHEASTERN UNIVERSITY, INC
Active
Parent organization
NOVA SOUTHEASTERN UNIVERSITY, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC
Authorized official
ROBERT S OLLER D.O. (CEO CLINICAL OPERATIONS)
(954) 262-4399
Entity
Organization
Contact information
Practice address
1050 NE 125TH STREET, NORTH MIAMI BEACH, FL 33161-5805
(305) 891-8850
(305) 891-3361
Mailing address
3200 S. UNIVERSITY DRIVE, SANFORD L. ZIFF BLDG. 3RD FLOOR ROOM 4364-D, FT. LAUDERDALE, FL 33328-2018
(954) 262-4343
(954) 262-2269
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/27/2011
Last updated
06/17/2011
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