FLORIDA ATLANTIC UNIVERSITY (NPI# 1164591954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164591954 |
| Entity Type | Organization |
| Organization Name | FLORIDA ATLANTIC UNIVERSITY |
| Other Organization Name | MEMORY AND WELLNESS CENTER |
| Practice Address |
777 Glades Rd Bldg Az-79 Boca Raton FL 33431-6424 |
| Practice Telephone | 5612970502 |
| Practice Fax Number | 5612970505 |
| Mailing Telephone | 5612970502 |
| Mailing Fax Number | 5612970505 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-01-13 |
| Authorized Official Name | MARLAINE SMITH (DEAN, NURSING) |
| Authorized Official Telephone | 5612973206 |
| Authorized Official Credential | RN, PHD, AHN-BC |
| Is Organization Subpart | Y |
| Parent Organization Name | FLORIDA ATLANTIC UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Memory and Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873975 | Florida Atlantic University | Speech-Language Pathologist | 777 Glades Rd Bldg 47, Rm 413, Boca Raton, FL 33431-6424 | 2019-10-25 |
| 1093026619 | Florida Atlantic University | Family Medicine | 1650 Osceola Drive, West Palm Beach, FL 33409 | 2010-06-29 |
| 1396211421 | Florida Atlantic University | Family Medicine | 880 Nw 13th St Ste 400, Boca Raton, FL 33486-2342 | 2018-10-16 |
| 1134510688 | Florida Atlantic University | Family Medicine | 777 Glades Rd, Department of Atlhletics, Boca Raton, FL 33431-6424 | 2015-02-05 |
| 1053736405 | Florida Atlantic University | Family Medicine | 777 Glades Rd, Building Bc-71, Room 237, Boca Raton, FL 33431-6424 | 2014-02-21 |
| 1659640076 | Florida Atlantic University | Local Education Agency (LEA) | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2011-12-14 |
| 1255541850 | Florida Atlantic University | Clinic/Center | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2007-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FLORIDA ATLANTIC UNIVERSITY | 777 Glades Rd, Boca Raton, FL 33431-6424 |
| System for Award Management (SAM) Entities | FLORIDA ATLANTIC UNIVERSITY - HARBOR BRANCH OCEANOGRAPHIC INSTITUTE (FAU-HBOI) | 5600 N Us Highway 1, Fort Pierce, FL 34946-7331 |
| Oklahoma Business Registrations | FLORIDA ATLANTIC UNIVERSITY FOUNDATION, INC. | 777 Glades Rd Admin, 295, Boca Raton, FL 33431 |
| System for Award Management (SAM) Entities | FLORIDA ATLANTIC UNIVERSITY RESEARCH CORPORATION | 777 Glades Rd, Boca Raton, FL 33431-6424 |
| Street Address |
777 GLADES RD BLDG AZ-79 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33431-6424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760408074 | James Edward Galvin | Psychiatry & Neurology | 777 Glades Rd, Me104, 1st Floor, Boca Raton, FL 33431-6424 | 2006-07-14 |
| 1427674928 | Marie Connell | Nurse Practitioner | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2020-06-19 |
| 1083233175 | Emily Rose Nelson | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Bc71 Room 315, Boca Raton, FL 33431-6496 | 2020-04-09 |
| 1891323085 | Ashley Elizabeth Gureck | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-04-01 |
| 1548896434 | Craig John Robinson Wilder | Preventive Medicine | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2020-03-23 |
| 1265068332 | Rachel Leeann Lewis | Preventive Medicine | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-03-20 |
| 1780210443 | Jared Goldstein | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-03-13 |
| 1487203931 | Noah Warren | Dietitian, Registered | 777 Glades Rd, Ss-8w Room 206b, Boca Raton, FL 33431-6496 | 2019-09-07 |
| 1982199428 | Allison Newsome | Specialist/Technologist | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2018-06-27 |
| 1225520901 | Adam Joseph Mann | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2018-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588272868 | Lifegaines Medical and Aesthetics | Preventive Medicine | 3785 N Federal Hwy, Suite 150, Boca Raton, FL 33431 | 2020-07-22 |
| 1285258756 | Gagan Neupane | Student in an Organized Health Care Education/Training Program | Florida Atlantic University At Boca Raton, 670 Glades Road, Suite 400, Boca Raton, FL 33431 | 2020-06-01 |
| 1407477821 | Paramount Medical Specialists | Preventive Medicine | 5550 Glades Road Suite, Ste 500, #1024, Boca Raton, FL 33431 | 2020-04-27 |
| 1497398358 | Dr Beverly Pedroche Inc | Psychologist | 4400 N, Federal Highway, Suite 210-48, Boca Raton, FL 33431 | 2019-10-23 |
| 1649829656 | William I Browning | Psychologist | 4400 North Federal Highway Suite #210, Boca Raton, FL 33431 | 2019-09-11 |
| 1275188898 | East Boca Pharmacy LLC | Pharmacy | 4800 Nw 2nd Ave, Suite 3, Boca Raton, FL 33431 | 2019-08-09 |
| 1790330504 | Connected Warriors | Psychologist | 950 Communications Ave Suite 115, Boca Raton, FL 33431 | 2019-08-08 |
| 1831652734 | Limitless Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 2263 Nw Boca Blvd, Ste 201, Boca Raton, FL 33431 | 2019-04-09 |
| 1659841211 | Tlc Medical Solutions | Durable Medical Equipment & Medical Supplies | 4800 Nw Boca Raton Blvd Suite 5, Boca Raton, FL 33431 | 2018-11-27 |
| 1750872545 | Sunstate Physicians LLC | Internal Medicine | 2234 N Federal Hwy Ste 531, Boca Raton, FL 33431 | 2018-05-29 |
| Find all providers in zip 33431 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548504129 | Madeline Michel | Nurse Practitioner | 21820 Cypress Cir, Apt 25b, Boca Raton, FL 33433-3215 | 2012-11-20 |
| 1811084460 | Maria De Los Angeles Ordonez | Nurse Practitioner | 10593 E Key Dr, Boca Raton, FL 33498-4510 | 2006-10-06 |
| 1447666086 | Kevin Patrick Hanaway | Nurse Practitioner | 1601 Clint Moore Rd, Suite 100, Boca Raton, FL 33487-2768 | 2014-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154896 | Christa Marie Mcnamara | Nurse Practitioner | 3820 Northdale Blvd Ste 107a, Tampa, FL 33624-1834 | 2020-11-03 |
| 1093315285 | Linh My Duong | Nurse Practitioner | 6184 49th Ave N, Kenneth City, FL 33709-3306 | 2020-10-28 |
| 1992304042 | Dawn Marie Decker-bowe | Nurse Practitioner | 7735 Hampton Hills Loop, New Port Richey, FL 34654-6206 | 2020-10-20 |
| 1770181182 | Lisa Maria Mercado | Nurse Practitioner | 8115 97th Ct, Vero Beach, FL 32967-2810 | 2020-10-16 |
| 1609474329 | Elisa Swieboda | Nurse Practitioner | 100 W Myrtle St, Howey In The Hills, FL 34737-4316 | 2020-10-14 |
| 1275130551 | Edgar Rafael Valdez Quinonez | Nurse Practitioner | 1212 Verdant Glade Pl, Winter Park, FL 32792-3029 | 2020-10-08 |
| 1306453683 | Madelyn Delgado Borges | Nurse Practitioner | 901 Tivoli Ter Apt 203, Deerfield Beach, FL 33441-7893 | 2020-09-30 |
| 1497362024 | Kyliene Reyes | Nurse Practitioner | 4771 Sw 138th Loop, Ocala, FL 34473-2000 | 2020-09-28 |
| 1598371882 | Curt David Miller | Nurse Practitioner | 5300 East Avenue West Palm Beach Fl, West Palm Beach, FL 33401 | 2020-09-22 |
| 1093321754 | Sangita Nair | Nurse Practitioner | 16302 Sw 23rd St, Miramar, FL 33027-4404 | 2020-09-18 |
| Find all providers with the same taxonomy | ||||
| City | BOCA RATON |
| Zip Code | 33431 |
Please comment or provide details below to improve the information on FLORIDA ATLANTIC UNIVERSITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.