# BOARD OF TRUSTEES OF FLORIDA ATLANTIC UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Florida Atlantic University Student Health Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972688992
- **Authorized official:** LOUISA PONTIROLI-KELLY (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (561) 297-2897

## Contact information

- **Practice address:** 777 GLADES RD, STUDENT HEALTH, BLDG SS-8W, ROOM 235, BOCA RATON, FL 33431-0991
- **Practice address phone:** (561) 297-0704
- **Practice address fax:** (561) 297-0221
- **Mailing address:** 777 GLADES RD, STUDENT HEALTH, BLDG SS-8W, ROOM 235, BOCA RATON, FL 33431-6424
- **Mailing address phone:** (561) 297-0704
- **Mailing address fax:** (561) 297-0221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | NOT REQUIRED | FL | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 04/15/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 110 | AMERICAN COLL HLTH ASSOC | — |