Organization
NOVA SOUTHEASTERN UNIVERSITY
Active
Organization
NOVA SOUTHEASTERN UNIVERSITY
Active
Other names
NSU - Center for Neuro Immune Disorders
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMERY ESTEVEZ (DIR CONTRACTING AND CRED)
(954) 262-4343
Entity
Organization
Contact information
Practice address
8501 SW 124TH AVE STE 111, MIAMI, FL 33183-4631
(305) 275-2601
(305) 274-8075
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
(305) 275-2601
(305) 274-8075
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
207K00000X
Allergy & Immunology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
680074-3
FL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/02/2009
Last updated
05/24/2023
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