NPIMap

Organization Active NPI

Nova Southeastern University, Inc

  • Clinical Medical Laboratory
  • Davie, FL
National Provider Identifier
1558799809
Registry record updated Oct 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC
Practice address
7595 SW 33Rd St
4TH Floor Suite 490
Davie, FL 33314-7708
Phone
(954) 262-2866
Fax
(954) 262-3850
NPI assigned
Oct 24, 2013
Last updated
Oct 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 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
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

7595 SW 33Rd St
4TH Floor Suite 490
Davie, FL 33314-7708

Mailing address

PO Box 290370
Davie, FL 33329-0370
Phone (954) 262-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101210000810 FL Part B Supplier - Independent Clinical Laboratory 4486568896 1 other NPI on this enrollment
Practice locations: Davie, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Opa Locka Family Health38 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": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792972800000",
    "number": "1558799809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290370",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333290370",
            "telephone_number": "954-262-4343",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 SW 33RD ST",
            "address_2": "4TH FLOOR SUITE 490",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147708",
            "telephone_number": "954-262-2866",
            "fax_number": "954-262-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "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": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.