Provider Demographics
NPI:1346524337
Name:ATLANTIC CARDIOLOGY & MEDICAL SPECIALISTS, PA
Entity Type:Organization
Organization Name:ATLANTIC CARDIOLOGY & MEDICAL SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-767-9585
Mailing Address - Street 1:731 DUNLAWTON AVE
Mailing Address - Street 2:SUITES 101 & 102
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4236
Mailing Address - Country:US
Mailing Address - Phone:386-767-9585
Mailing Address - Fax:386-767-9769
Practice Address - Street 1:731 DUNLAWTON AVE
Practice Address - Street 2:SUITES 101 & 102
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4236
Practice Address - Country:US
Practice Address - Phone:386-767-9585
Practice Address - Fax:386-767-9769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-08
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty