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General NPI Number Information
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NPI Number | 1689044687
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Entity Type | Organization
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Legal Business Name | PALM BEACH ATLANTIC UNIVERSITY
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 901 S FLAGER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-6505
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Country | US
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Telephone | 561-803-2338
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Fax | 561-370-7048
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Provider Business Mailing Address
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Address Line | 901 S FLAGER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-6505
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Country | US
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Telephone | 561-803-2338
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Fax | 561-370-7048
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Authorized Official
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Title or Position | ATHLETIC TRAINING ADMINISTRATOR
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Name | MRS. MICHELLE MENARD III
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Credential | DHSC, LAT, ATC
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Telephone | 561-803-2338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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