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

Contact information

Practice address
3501 JOHNSON STREET 2ND FLOOR SUITE 200, JOE DIMAGGIO CHILDREN'S HOSPITAL MEDICAL OFFICE CENTRE, HOLLYWOOD, FL 33021-5421
(954) 262-2187
(954) 262-2910
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
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
12/17/2008
Last updated
07/07/2011
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