Organization
FLORIDA ATLANTIC UNIVERSITY
Active
Parent organization
FLORIDA ATLANTIC UNIVERSITY
Other names
FAU Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA ATLANTIC UNIVERSITY
Authorized official
LOUISA PONTIROLI KELLY (CEO)
(561) 803-8880
Entity
Organization
Contact information
Practice address
1650 OSCEOLA DRIVE, WEST PALM BEACH, FL 33409
(561) 803-8880
(877) 409-1795
Mailing address
1650 OSCEOLA DR, WEST PALM BEACH, FL 33409-5038
(561) 803-8880
(877) 409-1795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002Z8
BCBS
FL
05
—
127082700
—
FL
05
—
127082701
—
FL
01
—
681903
FQHC MEDICARE 2021 FOR BOTH 1650 AND 720 LOCATIONS
FL
01
—
C11027
MEDICARE
FL
01
—
C7MZP
LUCET
FL
01
—
K3331C
MEDICARE
FL
Enumeration date
06/29/2010
Last updated
01/05/2026
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