Organization
FLORIDA ATLANTIC UNIVERSITY
Active
Other names
COLLEGE OF MEDICINE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISA PONTIROLI-KELLY (AUTHORIZED OFFICIAL)
(561) 297-2897
Entity
Organization
Contact information
Practice address
880 NW 13TH ST STE 400, BOCA RATON, FL 33486-2342
(561) 297-4814
Mailing address
777 GLADES ROAD, COLLEGE OF MEDICINE, BC-71, FINANCE OFFICE, BOCA RATON, FL 33431
(561) 566-5328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/16/2018
Last updated
03/24/2024
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