Provider Demographics
NPI: | 1326386848 |
---|---|
Name: | NOVA SOUTHEASTERN UNIVERSITY |
Entity type: | Organization |
Organization Name: | NOVA SOUTHEASTERN UNIVERSITY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIR CONTRACTING AND CRED |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROSEMERY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ESTEVEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 954-262-4343 |
Mailing Address - Street 1: | PO BOX 290370 |
Mailing Address - Street 2: | |
Mailing Address - City: | DAVIE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33329-0370 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-262-4343 |
Mailing Address - Fax: | 954-262-2271 |
Practice Address - Street 1: | 7595 SW 33RD ST FL 4 |
Practice Address - Street 2: | |
Practice Address - City: | DAVIE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33314-7708 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-262-4343 |
Practice Address - Fax: | 954-262-2271 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-01-17 |
Last Update Date: | 2024-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RA0201X | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |