Nova Southeastern University, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NOVA SOUTHEASTERN UNIVERSITY, INC

Practice address

3625 College Ave Ste 135
Davie, FL 33314-7724

Phone

(954) 262-4100

NPI assigned

Dec 2, 2020

Last updated

Dec 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosemery Estevez

Title

Credentialing and Contracting Dir

Phone

(954) 262-4343

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 2

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.

• Robert S. Oller, D.O.

  • Family Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1811268626
  NPD
• Marilyn S Gordon, LD/N

  • Registered Dietitian
  • Davie, FL
  • NPI 1679751556
  NPD (past)

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1922603422",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 COLLEGE AVE STE 135",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147724",
            "telephone_number": "954-262-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA SOUTHEASTERN UNIVERSITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "ESTEVEZ",
        "authorized_official_first_name": "ROSEMERY",
        "authorized_official_title_or_position": "CREDENTIALING AND CONTRACTING DIR",
        "authorized_official_telephone_number": "954-262-4343"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "59-1083502",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "3625 College Ave Ste 135",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333147724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nova Southeastern University, Inc
• Nova Southeastern University, Inc
• Nova Southeastern University, Inc
• Nova Southeastern University, Inc
• Nova Southeastern University, Inc
• Nova Southeastern University, Inc.
• Michael Nova
• Novick Chiropractic P a
• Novick Medical Supply
• Laurence Richard Novick, DC

• Family Medicine Physician in Davie, FL
• Providers in Davie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.