Provider Demographics
NPI:1104154525
Name:ATLANTIC DIAGNOSTICS INC.
Entity type:Organization
Organization Name:ATLANTIC DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:TURCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-703-9380
Mailing Address - Street 1:1001 E SAMPLE RD
Mailing Address - Street 2:SUITE E6
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5161
Mailing Address - Country:US
Mailing Address - Phone:954-703-9380
Mailing Address - Fax:
Practice Address - Street 1:1001 E SAMPLE RD
Practice Address - Street 2:SUITE E6
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5161
Practice Address - Country:US
Practice Address - Phone:954-703-9380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory