NPIMap

Organization Active NPI

Nova Southeastern University, Inc

  • General Practice Dentistry
  • Davie, FL
National Provider Identifier
1811288012
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC
Practice address
7600 SW 36TH Street
BLDG. # 100 Room 1263
Davie, FL 33328-1902
Phone
(954) 262-7127
Fax
(954) 262-3937
NPI assigned
Apr 22, 2011
Last updated
Jun 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NOVA SOUTHEASTERN UNIVERSITY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Rosemery Estevez
Title
Dir Contracting and Credentialing
Phone
(954) 262-4343

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X NU
General Practice Dentistry 1223G0001X NU Primary
Pediatric Dentistry 1223P0221X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU
Nutritionist 133N00000X NU
Pediatric Nutrition Registered Dietitian 133VN1004X NU
Pediatrics Physician 208000000X NU
Physical Therapist 225100000X NU
Pediatric Physical Therapist 2251P0200X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

7600 SW 36TH Street
BLDG. # 100 Room 1263
Davie, FL 33328-1902

Mailing address

3200 S. University Drive
Sanford L. Ziff BLDG. 3Rd Floor Room 4364-D
Ft. Lauderdale, FL 33328-2018
Phone (954) 262-4343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000987 FL Part B Supplier - Clinic/Group Practice 4486568896 Receives reassigned benefits from 259 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Davie, FL; Wilton Manors, FL; Sunrise, FL; Plantation, FL; North Miami Beach, FL; Miami, FL; Ft Lauderdale, FL; Fort Lauderdale, FL

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Nova SE Univ38 organizations share this tax ID, including this one
Part of
Nova SE Univ

Other organizations with this tax ID 37

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

View all 37

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1811288012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S. UNIVERSITY DRIVE",
            "address_2": "SANFORD L. ZIFF BLDG. 3RD FLOOR ROOM 4364-D",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "333282018",
            "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": "7600 SW 36TH STREET",
            "address_2": "BLDG. # 100 ROOM 1263",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281902",
            "telephone_number": "954-262-7127",
            "fax_number": "954-262-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "enumeration_date": "2011-04-22",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "ESTEVEZ",
        "authorized_official_first_name": "ROSEMERY",
        "authorized_official_title_or_position": "DIR CONTRACTING AND CREDENTIALING",
        "authorized_official_telephone_number": "954-262-4343"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 11, 2025; 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.