Organization Name: | NOVA SOUTHEASTERN UNIVERSITY, INC |
NPI Number: | 1700924511 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT OLLER (CEO/CLINICAL OPERATIONS) |
Mailing Address: | 650 North Andrews Avenue Ft. Lauderdale |
State: | FL US |
Postal Code: | 333117436 |
Phone Number: | 9542624100 |
Fax Number: | 9542626888 |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 06/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |