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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