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Organization
NOVA SOUTHEASTERN UNIVERSITY, INC.
Active
Organization
NOVA SOUTHEASTERN UNIVERSITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT S OLLER D.O. (CEO)
(954) 262-4399
Entity
Organization
Contact information
Practice address
3200 S UNIVERSITY DR, ASSEMBLY BUILDING II, SUITE 202, DAVIE, FL 33328-2018
(954) 262-4399
(954) 262-1172
Mailing address
3200 S UNIVERSITY DR, ASSEMBLY BUILDING II, SUITE 202, DAVIE, FL 33328-2018
(954) 262-4399
(954) 262-1172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS2443
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS 2443
MEDICAL LICENSE
FL
Enumeration date
04/19/2006
Last updated
08/22/2020
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