Provider Demographics
NPI:1952329989
Name:ATLANTIS MEDICAL INC
Entity Type:Organization
Organization Name:ATLANTIS MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGUYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-485-8619
Mailing Address - Street 1:8672 SW 40 ST
Mailing Address - Street 2:207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-485-8619
Mailing Address - Fax:305-485-8609
Practice Address - Street 1:8672 BIRD RD
Practice Address - Street 2:207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3265
Practice Address - Country:US
Practice Address - Phone:305-485-8619
Practice Address - Fax:305-485-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation