Provider Demographics
NPI:1225327851
Name:ATLANTIC THERAPY GROUP, LLC
Entity Type:Organization
Organization Name:ATLANTIC THERAPY GROUP, LLC
Other - Org Name:A TO Z MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:407-244-5554
Mailing Address - Street 1:6645 VINELAND RD STE 270
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7840
Mailing Address - Country:US
Mailing Address - Phone:407-244-5554
Mailing Address - Fax:
Practice Address - Street 1:6645 VINELAND RD STE 270
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7840
Practice Address - Country:US
Practice Address - Phone:407-244-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4284111N00000X
FLPT 19588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty