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General NPI Number Information
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NPI Number | 1659640076
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Entity Type | Organization
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Legal Business Name | FLORIDA ATLANTIC UNIVERSITY
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 04/15/2023
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Provider Practice Location Address
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Address Line | 777 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33431-6424
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Country | US
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Telephone | 561-297-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 777 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33431-6424
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Country | US
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Telephone | 561-297-0777
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LOUISA PONTIROLI-KELLY
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Credential |
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Telephone | 561-297-2897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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