Provider Demographics
NPI:1316543192
Name:ATP HEALTHCARE
Entity Type:Organization
Organization Name:ATP HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:POORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-624-5661
Mailing Address - Street 1:406 E KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-2432
Mailing Address - Country:US
Mailing Address - Phone:138-662-4566
Mailing Address - Fax:386-279-7239
Practice Address - Street 1:406 E KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-2432
Practice Address - Country:US
Practice Address - Phone:138-662-4566
Practice Address - Fax:386-279-7239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management