# FAU BROWARD HEALTH ACADEMIC PRACTICE PLAN INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447092325
- **Authorized official:** DR. JERRY CAPOTE MD (MD/CEO)
- **Authorized official phone:** (954) 786-6449

## Contact information

- **Practice address:** 1 W SAMPLE RD STE 301, DEERFIELD BEACH, FL 33064-3547
- **Practice address phone:** (954) 958-7195
- **Practice address fax:** (954) 958-7115
- **Mailing address:** 2100 E SAMPLE RD STE 101, LIGHTHOUSE POINT, FL 33064-7574
- **Mailing address phone:** (954) 958-7195
- **Mailing address fax:** (954) 958-7115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2024
- **Last updated:** 08/20/2024