Provider Demographics
NPI:1205180973
Name:PALM BEACH ATLANTIC UNIVERSITY
Entity Type:Organization
Organization Name:PALM BEACH ATLANTIC UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HEALTH AND WELLNESS
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:KIRKLAND
Authorized Official - Last Name:BIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:561-803-2535
Mailing Address - Street 1:901 SOUTH FLAGLER DR. P.O. BOX 24708
Mailing Address - Street 2:HEALTH AND WELLNESS CENTER
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-4708
Mailing Address - Country:US
Mailing Address - Phone:561-803-2576
Mailing Address - Fax:561-803-2499
Practice Address - Street 1:1000 SOUTH DIXIE HWY
Practice Address - Street 2:HEALTH AND WELLNESS CENTER
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33416-4708
Practice Address - Country:US
Practice Address - Phone:561-803-2576
Practice Address - Fax:561-803-2499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALM BEACH ATLANTIC UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care