NPIMap

Organization Active NPI

Nova Southeastern University, Inc

  • Occupational Therapist
  • Davie, FL
National Provider Identifier
1922550003
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NOVA SOUTHEASTERN UNIVERSITY, INC
Practice address
3375 SW 75TH Ave
Room 1021
Davie, FL 33314-1400
Phone
(954) 262-4149
Fax
(954) 262-1788
NPI assigned
Oct 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Robert Oller, DO
Title
Chief Medical Advisor
Phone
(954) 262-4343

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

3375 SW 75TH Ave
Room 1021
Davie, FL 33314-1400

Mailing address

3375 SW 75TH Ave
Room 1021
Davie, FL 33314-1400
Phone (954) 262-4149

National Provider Directory

National Provider Directory
Tax ID family
Nova Southeaster 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

Locations

3375 SW 75th Ave
Rm 1021
Davie, FL 33314
Phone (954) 262-4149

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1922550003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 SW 75TH AVE",
            "address_2": "ROOM 1021",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141400",
            "telephone_number": "954-262-4149",
            "fax_number": "954-262-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 SW 75TH AVE",
            "address_2": "ROOM 1021",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141400",
            "telephone_number": "954-262-4149",
            "fax_number": "954-262-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "OLLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF MEDICAL ADVISOR",
        "authorized_official_telephone_number": "954-262-4343",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "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 Dec 5, 2023; 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.