Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Florida Atlantic University

Organization Clinical Neuropsychologist · NPI 1164591954

Florida Atlantic University is a Clinical Neuropsychologist in Boca Raton, Florida. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
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Practice location Address checks out

777 Glades Rd Bldg AZ-79
Boca Raton, FL 33431-6424
Phone: (561) 297-0502
Fax: (561) 297-0505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X
Clinical Neuropsychologist Taxonomy 103G00000X
Clinical Psychologist Taxonomy 103TC0700X

Record details

NPI number1164591954
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFlorida Atlantic University
Authorized official Louisa Pontiroli-Kelly — Authorized Official · (561) 297-2897
Other names Memory And Wellness Center; Memory And Wellness Center
NPI enumeratedNovember 7, 2006
Last updated in NPPESDecember 15, 2025
Certification dateDecember 15, 2025
Mailing address777 Glades Rd Bldg Az-79, Boca Raton, FL 33431-6424

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