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Organization
BOARD OF TRUSTEES OF FLORIDA ATLANTIC UNIVERSITY
Active
Organization
BOARD OF TRUSTEES OF FLORIDA ATLANTIC UNIVERSITY
Active
Other names
Florida Atlantic University Student Health Services
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, STUDENT HEALTH, BLDG SS-8W, ROOM 235, BOCA RATON, FL 33431-0991
(561) 297-0704
(561) 297-0221
Mailing address
777 GLADES RD, STUDENT HEALTH, BLDG SS-8W, ROOM 235, BOCA RATON, FL 33431-6424
(561) 297-0704
(561) 297-0221
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
NOT REQUIRED
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110
AMERICAN COLL HLTH ASSOC
—
Enumeration date
10/26/2006
Last updated
04/15/2023
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