Provider Demographics
NPI:1245521319
Name:ATLANTIC MED HEALTH CARE
Entity type:Organization
Organization Name:ATLANTIC MED HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARENCIBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-552-7800
Mailing Address - Street 1:2151 S LE JEUNE RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4200
Mailing Address - Country:US
Mailing Address - Phone:786-552-7800
Mailing Address - Fax:
Practice Address - Street 1:4799 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2933
Practice Address - Country:US
Practice Address - Phone:786-552-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty