Florida Atlantic University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

FLORIDA ATLANTIC UNIVERSITY

Practice address

777 Glades Rd
Department of Atlhletics
Boca Raton, FL 33431-6424

Phone

(800) 555-9073

Fax

(972) 367-3452

NPI assigned

Feb 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mouzon Bass III

Title

Agent

Phone

(800) 555-9073

Specialties & licenses 2

Addresses

Other names 1

• FAU Sports Medicine Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1134510688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "address_2": "DEPARTMENT OF ATLHLETICS",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ATLANTIC UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "800-555-9073",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley N Flores, LCSW-C, CAC-AD
• Victor Flores
• Laura Florez
• Florida Atlantic Orthopedics LLC
• Florida Atlantic University
• Florida Atlantic University
• Florida Atlantic University
• Florida Atlantic University
• Florida Atlantic University
• Florida Atlantic University

• Orthopaedic Surgery Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.