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

Florida Atlantic University

Organization Family Medicine Physician · NPI 1396211421

Florida Atlantic University is a Family Medicine Physician in Boca Raton, Florida. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2

Practice location Address checks out

880 NW 13th St Ste 400
Boca Raton, FL 33486-2342
Phone: (561) 297-4814
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1396211421
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Louisa Pontiroli-Kelly — Authorized Official · (561) 297-2897
Other names College Of Medicine Clinic
NPI enumeratedOctober 16, 2018
Last updated in NPPESMarch 24, 2024
Certification dateMarch 24, 2024
Mailing address777 Glades Road, College Of Medicine, Bc-71, Finance Office, Boca Raton, FL 33431

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