| Board Of Trustees Of Florida Atlantic University | |
|
777 Glades Rd Student Health, Bldg Ss-8w, Room 235 Boca Raton FL 33431-0991 | |
| (561) 297-0704 | |
| (561) 297-0221 |
| Full Name | Board Of Trustees Of Florida Atlantic University |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 777 Glades Rd, Boca Raton, Florida |
| Authorized Official Name and Position | Louisa Pontiroli-kelly (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5612972897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of Florida Atlantic University 777 Glades Rd Student Health, Bldg Ss-8w, Room 235 Boca Raton FL 33431-6424 Ph: (561) 297-0704 | Board Of Trustees Of Florida Atlantic University 777 Glades Rd Student Health, Bldg Ss-8w, Room 235 Boca Raton FL 33431-0991 Ph: (561) 297-0704 |
| NPI Number | 1972688992 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 04/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972688992 | NPI | - | NPPES |
| 110 | Other | AMERICAN COLL HLTH ASSOC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | NOT REQUIRED (Florida) | Primary |
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