| Nova Southeastern University, Inc. | |
|
3200 S University Dr Assembly Building Ii, Suite 202 Davie FL 33328-2018 | |
| (954) 262-4399 | |
| (954) 262-1172 |
| Full Name | Nova Southeastern University, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3200 S University Dr, Davie, Florida |
| Authorized Official Name and Position | Robert S Oller (CEO) |
| Authorized Official Contact | 9542624399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Southeastern University, Inc. 3200 S University Dr Assembly Building Ii, Suite 202 Davie FL 33328-2018 Ph: (954) 262-4399 | Nova Southeastern University, Inc. 3200 S University Dr Assembly Building Ii, Suite 202 Davie FL 33328-2018 Ph: (954) 262-4399 |
| NPI Number | 1780649194 |
|---|---|
| Provider Enumeration Date | 04/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780649194 | NPI | - | NPPES |
| OS 2443 | Other | FL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS2443 (Florida) | Primary |
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