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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
ROSEMERY ESTEVEZ (DIR CONTRACTING AND CREDENTIALING)
(954) 262-4343
Entity
Organization

Contact information

Practice address
1600 S ANDREWS AVE, WEST WING 3RD FLOOR, FT LAUDERDALE, FL 33316-2510
(954) 355-5703
(954) 355-5490
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
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary

Other

Enumeration date
08/18/2008
Last updated
05/30/2023
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