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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
ROSEMERY ESTEVEZ (DIRECTOR OF CONTRACTING)
(954) 262-4100
Entity
Organization
Contact information
Practice address
1625 SE 3RD AVE STE 802, FT LAUDERDALE, FL 33316-2521
(954) 262-7500
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
(954) 262-4343
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
09/16/2026
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