MEDICARE: NOVA SOUTHEASTERN UNIVERSITY INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	227800000X	Certified Respiratory Therapist
4	235Z00000X	Speech-Language Pathologist
5	103T00000X	Psychologist
6	133N00000X	Nutritionist
7	363LF0000X	Family Nurse Practitioner
8	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1760126114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA SOUTHEASTERN UNIVERSITY INC.

Provider Business Mailing Address
First Line	:	PO BOX 290370
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33329-0370
Country	:	US
Telephone Number	:	954-262-3434
Fax Number	:

Provider Business Practice Location Address
First Line	:	7595 SW 33RD ST STE 204
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-7708
Country	:	US
Telephone Number	:	954-262-6387
Fax Number	:

Authorized Official
Title or Position	:	CONTRACTING DIRECTOR
Name	:	ROSEMERY ESTEVEZ
Credential	:
Telephone Number	:	786-262-4343

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	06/12/2025

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