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FLORIDA ATLANTIC UNIVERSITY NPI 1164591954


NPI Information

NPI: 1164591954
Provider Name: FLORIDA ATLANTIC UNIVERSITY

Doing Business As: MEMORY AND WELLNESS CENTER

Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
777 GLADES RD
BLDG AZ-79
BOCA RATON, FL
ZIP 33431
Phone: (561) 297-0502
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FLORIDA ATLANTIC UNIVERSITY is a gerontology nurse practitioner in Boca Raton, FL. FLORIDA ATLANTIC UNIVERSITY NPI is 1164591954. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memory And Wellness Center.

The provider's business location address is:

777 GLADES RD
BLDG AZ-79
BOCA RATON, FL
ZIP 33431-424
Phone: (561) 297-0502
Fax: (561) 297-0505

The provider's authorized official is Gregory Debois .
The authorized official title is Authorized Official and has the following contact phone number (561) 297-4814.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 2/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical NeuropsychologistNo
2103TC0700XPsychologistClinicalNo
3363LG0600XNurse PractitionerGerontologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.