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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
DR. ROBERT S OLLER D.O. (CEO/CLINICAL OPERATIONS)
(954) 262-4343
Entity
Organization

Contact information

Practice address
7600 SW 36TH STREET, FT. LAUDERDALE, FL 33328-1902
(954) 262-2917
(954) 262-2917
Mailing address
3200 S UNIVERSITY DRIVE, SANFORD L. ZIFF BLDG. 3RD FLOOR, ROOM 4364-D, DAVIE, FL 33328-2018
(954) 262-4343
(954) 262-2269

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
05/01/2008
Last updated
06/16/2011
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