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Organization
FLORIDA ATLANTIC UNIVERSITY
Active
Organization
FLORIDA ATLANTIC UNIVERSITY
Active
Other names
Florida Atlantic University Alzheimer's Prevention Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISA PONTIROLI-KELLY (AUTHORIZED OFFICIAL)
(561) 297-2897
Entity
Organization
Contact information
Practice address
777 GLADES RD, OFFICE BUILDING 1, BOCA RATON, FL 33431-6496
(561) 566-5328
(561) 299-4220
Mailing address
777 GLADES RD, OFFICE BUILDING 1, BOCA RATON, FL 33431-6496
(561) 566-5328
(561) 299-4220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
311500000X
Alzheimer Center (Dementia Center)
Primary
—
NULL
Other
Enumeration date
02/21/2014
Last updated
04/23/2023
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