MEDICARE: NOVA SOUTHEASTERN UNIVERSITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	104100000X	Social Worker
3	1041C0700X	Clinical Social Worker
4	133N00000X	Nutritionist
5	133V00000X	Registered Dietitian
6	207R00000X	Internal Medicine Physician
7	2084N0400X	Neurology Physician
8	225100000X	Physical Therapist
9	225X00000X	Occupational Therapist
10	227900000X	Registered Respiratory Therapist
11	235Z00000X	Speech-Language Pathologist
12	363LF0000X	Family Nurse Practitioner
13	207RA0201X	Allergy & Immunology (Internal Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326386848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA SOUTHEASTERN UNIVERSITY

Provider Business Mailing Address
First Line	:	PO BOX 290370
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33329-0370
Country	:	US
Telephone Number	:	954-262-4343
Fax Number	:	954-262-2271

Provider Business Practice Location Address
First Line	:	7595 SW 33RD ST FL 4
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-7708
Country	:	US
Telephone Number	:	954-262-4343
Fax Number	:	954-262-2271

Authorized Official
Title or Position	:	DIR CONTRACTING AND CRED
Name	:	ROSEMERY ESTEVEZ
Credential	:
Telephone Number	:	954-262-4343

Provider Enumeration Date	:	01/17/2013
Last Update Date	:	03/26/2024

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Directions to “NOVA SOUTHEASTERN UNIVERSITY ” Practice Location

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