Provider Demographics
NPI:1770156838
Name:ATLANTIC HEALTH MEDICAL, INC
Entity type:Organization
Organization Name:ATLANTIC HEALTH MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:VOLRICK
Authorized Official - Middle Name:DARRELL
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-931-7424
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4709
Mailing Address - Country:US
Mailing Address - Phone:305-931-7424
Mailing Address - Fax:305-931-7425
Practice Address - Street 1:1380 NE MIAMI GARDENS DR STE 210
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4709
Practice Address - Country:US
Practice Address - Phone:305-931-7424
Practice Address - Fax:305-931-7425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001336200Medicaid