NOVA SOUTHEASTERN UNIVERSITY, INC. (NPI# 1548406812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548406812 |
| Entity Type | Organization |
| Organization Name | NOVA SOUTHEASTERN UNIVERSITY, INC. |
| Practice Address |
3501 Johnson Street 2nd Floor Suite 200 Joe Dimaggio Children's Hospital Medical Office Centre Hollywood FL 33021-5421 |
| Mailing Address |
3200 S University Drive Sanford L. Ziff Bldg. 3rd Floor, Room 4364-d Ft. Lauderdale FL 33328-2018 |
| Practice Telephone | 9542622187 |
| Practice Fax Number | 9542622910 |
| Mailing Telephone | 9542624343 |
| Mailing Fax Number | 9542622269 |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2011-07-07 |
| Authorized Official Name | ROBERT S. OLLER (CLINICAL OPERATIONS) |
| Authorized Official Telephone | 9542624343 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | Y |
| Parent Organization Name | NOVA SOUTHEASTERN UNIVERSITY, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902119985 | Nova Southeastern University, Inc. | Optometrist | 819 Ne 26th Street, Wilton Manors, FL 33305-1239 | 2010-07-20 |
| 1720126584 | Nova Southeastern University, Inc. | Neuromusculoskeletal Medicine & OMM | 3301 College Ave, University Center Room 1433, Ft. Lauderdale, FL 33314-7721 | 2007-02-02 |
| 1780649194 | Nova Southeastern University, Inc. | Family Medicine | 3200 S University Dr, Assembly Building II, Suite 202, Davie, FL 33328-2018 | 2006-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Fort Lauderdale, FL 33314-7721 |
| Colorado Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | Nova Southeastern University, 3301 College Ave - Licensure, Fort Lauderdale, FL 33314 |
| Iowa Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Ft Lauderdale, FL 33314 |
| Oregon Corporations, Companies and Business Names | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Fort Lauderdale, FL 33314 |
| Vermont Business Registrations | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Avenue, Ft. Lauderdale, FL 33314 |
| Indiana Business Entities | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Avenue, Fort Lauderdale, FL 33314 |
| Washington State Corporations | NOVA SOUTHEASTERN UNIVERSITY, INC. | 3301 College Ave, Fort Lauderdale, FL 33314 |
| Street Address |
3501 JOHNSON STREET 2ND FLOOR SUITE 200 JOE DIMAGGIO CHILDREN'S HOSPITAL MEDICAL OFFICE CENTRE |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-5421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013376318 | Yamila Garber | Dentist | 9720 Stirling Rd Ste 100, Hollywood, FL 33024 | 2016-02-15 |
| 1700103686 | Claudia Johana Rodriguez | Dentist | 5000 Hollywood Blvd Ste 1, Hollywood, FL 33021-6530 | 2010-04-30 |
| 1689727067 | Ronald B Marx | Dentist | 5000 Hollywood Blvd, Suite 1, Hollywood, FL 33021-6530 | 2007-01-19 |
| 1689271421 | Shelly Levin Pllc | Dentist | 1005 Joe Dimaggio Dr, Hollywood, FL 33021-5402 | 2020-10-05 |
| 1912398603 | Baitner Pediatric Dentistry | Dentist | 4480 Sheridan St, Hollywood, FL 33021-3511 | 2015-02-17 |
| 1316388820 | Marvin Antonio Abarca | Dentist | 9900 Stirling Rd Ste 100, Hollywood, FL 33024 | 2013-07-12 |
| 1053652941 | Sandra Brener Dss Pa | Dentist | 9720 Stirling Rd, Suite 100, Hollywood, FL 33024-8013 | 2013-03-03 |
| 1932356391 | Sandra R Brener | Dentist | 9720 Stirling Rd, Suite 100, Hollywood, FL 33024-8013 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113296 | Pediatric Dental Center of Gardens Inc | Dentist | 18244 Nw 27th Ave, Miami Gardens, FL 33056-3501 | 2020-10-27 |
| 1205446598 | Harp Pediatric Dentistry | Dentist | 31067 Us Highway 19 N, Palm Harbor, FL 34684-4416 | 2020-08-03 |
| 1043829377 | Little Champions Pediatric Dentistry | Dentist | 1330 Sw 22nd St Ste 406, Miami, FL 33145-2945 | 2020-07-22 |
| 1710595509 | Bright Smiles Pediatric Dentistry Nassau LLC | Dentist | 960135 Gateway Blvd, Fernandina Beach, FL 32034-9120 | 2020-07-17 |
| 1578180097 | Juliana Grace Fitzgerald | Dentist | 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 | 2020-06-30 |
| 1861012569 | Toni-marie Small | Dentist | 12625 76th Rd N, West Palm Beach, FL 33412-2259 | 2020-04-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1114573086 | Kids Dentist LLC | Dentist | 8058 W Mcnab Rd, North Lauderdale, FL 33068-4254 | 2019-08-15 |
| 1558915157 | Dentistry for Children of Florida, Pllc | Dentist | 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 | 2019-07-31 |
| 1528620937 | Catherine Jane Graham | Dentist | 1395 Center Dr Rm D11-6, Gainesville, FL 32610-3006 | 2019-07-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.