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 OOPERATIONS)
(954) 262-4343
Entity
Organization
Contact information
Practice address
3301 COLLEGE AVE, ROOM 1441 - UNIVERSITY CENTER, DAVIE, FL 33314
(954) 262-4100
(954) 262-1788
Mailing address
PO BOX 290250, DAVIE, FL 33329-0250
(954) 262-4100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886463200
—
FL
Enumeration date
02/09/2009
Last updated
05/17/2018
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