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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 OF CONTRACTING AND CREDEN)
(954) 262-4343
Entity
Organization

Contact information

Practice address
3301 COLLEGE AVE, UNIVERSITY CENTER ROOM 1433, FT. LAUDERDALE, FL 33314-7721
(954) 262-5590
(954) 262-5570
Mailing address
3200 S UNIVERSITY DR, SANFORD L. ZIFF BLDG, 3RD FLOOR, ROOM 4364-D, FORT LAUDERDALE, FL 33328-2018
(954) 262-4343
(954) 262-1172

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
133N00000X
Nutritionist
133V00000X
Registered Dietitian
152W00000X
Optometrist
171100000X
Acupuncturist
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
225100000X
Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
98673
MEDICARE GROUP NUMBER
FL
Enumeration date
02/02/2007
Last updated
05/24/2023
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