Provider Demographics
NPI:1306851001
Name:ATLAS PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:ATLAS PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:727-785-8256
Mailing Address - Street 1:PO BOX 2165
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-2165
Mailing Address - Country:US
Mailing Address - Phone:727-785-8256
Mailing Address - Fax:727-785-8946
Practice Address - Street 1:5004 MILE STRETCH DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-4431
Practice Address - Country:US
Practice Address - Phone:727-785-8256
Practice Address - Fax:727-785-8946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891819896OtherMEDICAID WAIVER
FL891819800Medicaid
FL891819896OtherMEDICAID WAIVER