Provider Demographics
NPI:1154037869
Name:ATLANTIS HEALTH CLINIC, LLC
Entity type:Organization
Organization Name:ATLANTIS HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-536-7779
Mailing Address - Street 1:9380 SW 72ND ST STE B238
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5483
Mailing Address - Country:US
Mailing Address - Phone:786-307-6297
Mailing Address - Fax:786-732-1081
Practice Address - Street 1:9380 SW 72ND ST STE B238
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5483
Practice Address - Country:US
Practice Address - Phone:786-875-9769
Practice Address - Fax:786-732-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy