Provider Demographics
NPI:1205218070
Name:ATLAS MEDICAL AND ORTHOPEDICS
Entity Type:Organization
Organization Name:ATLAS MEDICAL AND ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:FADERANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-425-5757
Mailing Address - Street 1:6864 FOREST HILL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3339
Mailing Address - Country:US
Mailing Address - Phone:561-425-5757
Mailing Address - Fax:888-663-8123
Practice Address - Street 1:6864 FOREST HILL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3339
Practice Address - Country:US
Practice Address - Phone:561-425-5757
Practice Address - Fax:888-663-8123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10474207RS0010X
FLME115180207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty