Provider Demographics
NPI:1245363423
Name:ATLANTIC CARDIOLOGY ENTERPRISES, INC.
Entity type:Organization
Organization Name:ATLANTIC CARDIOLOGY ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAYER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:386-295-2938
Mailing Address - Street 1:PO BOX 1655
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32175-1655
Mailing Address - Country:US
Mailing Address - Phone:386-295-2938
Mailing Address - Fax:386-441-4420
Practice Address - Street 1:695 N CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2321
Practice Address - Country:US
Practice Address - Phone:386-295-2938
Practice Address - Fax:386-441-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID