Provider Demographics
NPI:1518024942
Name:ATLANTIC RESPIRATORY SERVICES
Entity Type:Organization
Organization Name:ATLANTIC RESPIRATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:APPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-760-2006
Mailing Address - Street 1:3959 S NOVA RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-9278
Mailing Address - Country:US
Mailing Address - Phone:386-760-2006
Mailing Address - Fax:
Practice Address - Street 1:3959 S NOVA RD
Practice Address - Street 2:SUITE 19
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9278
Practice Address - Country:US
Practice Address - Phone:386-760-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2138332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4818670001Medicare ID - Type Unspecified