NPIMap

Organization Active NPI

Nova Southeastern University, Inc

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1245773779
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC
Practice address
1201 W Cypress Creek Rd
2ND Floor Suite 102
Fort Lauderdale, FL 33309-1906
Phone
(954) 262-7530
Fax
(954) 568-7749
NPI assigned
Dec 1, 2016
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julissa Lazala
Title
Director of Revenue Cycle
Phone
(954) 262-4946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1201 W Cypress Creek Rd
2ND Floor Suite 102
Fort Lauderdale, FL 33309-1906

Mailing address

1201 W Cypress Creek Rd
2ND Floor Suite 102
Fort Lauderdale, FL 33309-1906
Phone (954) 262-7530

National Provider Directory

National Provider Directory
Tax ID family
Nova Southeastern Univ38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1245773779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W CYPRESS CREEK RD",
            "address_2": "2ND FLOOR SUITE 102",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091906",
            "telephone_number": "954-262-7530",
            "fax_number": "954-568-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W CYPRESS CREEK RD",
            "address_2": "2ND FLOOR SUITE 102",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091906",
            "telephone_number": "954-262-7530",
            "fax_number": "954-568-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-01",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "LAZALA",
        "authorized_official_first_name": "JULISSA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "954-262-4946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.