NPIMap

Organization Active NPI

Board of Trustees of Florida Atlantic University

  • Student Health Clinic/Center
  • Boca Raton, FL
National Provider Identifier
1972688992
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
NOT REQUIRED Issued in FL
Legal business name
BOARD OF TRUSTEES OF FLORIDA ATLANTIC UNIVERSITY
Practice address
777 Glades Rd
Student Health, BLDG SS-8W, Room 235
Boca Raton, FL 33431-0991
Phone
(561) 297-0704
Fax
(561) 297-0221
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Authorized official

Name
Louisa Pontiroli-Kelly
Title
Authorized Official
Phone
(561) 297-2897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X NOT REQUIRED FL Primary

Addresses

Primary practice location

777 Glades Rd
Student Health, BLDG SS-8W, Room 235
Boca Raton, FL 33431-0991

Mailing address

777 Glades Rd
Student Health, BLDG SS-8W, Room 235
Boca Raton, FL 33431-6424
Phone (561) 297-0704

Other identifiers 1

IdentifierTypeStateIssuer
110OtherAMERICAN COLL HLTH ASSOC

Other names 1

  • Florida Atlantic University Student Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Board of Trustees of Florida Atlantic University8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681516800000",
    "number": "1972688992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "address_2": "STUDENT HEALTH, BLDG SS-8W, ROOM 235",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "561-297-0704",
            "fax_number": "561-297-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "address_2": "STUDENT HEALTH, BLDG SS-8W, ROOM 235",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334310991",
            "telephone_number": "561-297-0704",
            "fax_number": "561-297-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES OF FLORIDA ATLANTIC UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A",
        "authorized_official_last_name": "PONTIROLI-KELLY",
        "authorized_official_first_name": "LOUISA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-297-2897"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "FL",
            "license": "NOT REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN COLL HLTH ASSOC",
            "identifier": "110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Atlantic University Student Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Atlantic University Student Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2023; 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.