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. ROSEMERY ESTEVEZ (CONTRACTING DIRECTOR)
(954) 262-4343
Entity
Organization
Contact information
Practice address
1111 W BROWARD BLVD, FT LAUDERDALE, FL 33312-1638
(954) 525-1351
(954) 779-1770
Mailing address
3200 S UNIVERSITY DRIVE, SANFORD L. ZIFF BLDG. 3RD FLOOR, ROOM 4364-D, FT. LAUDERDALE, FL 33328-2018
(954) 262-4343
(954) 262-1172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078488500
—
FL
01
—
98673A
MEDICARE GROUP NUMBER
FL
Enumeration date
02/02/2007
Last updated
07/11/2023
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