MEDICARE: ATLANTA HO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18867	NE
2	183500000X	Pharmacist	RPH036040	GA
3	183500000X	Pharmacist	PS68211	FL

General Provider Information

NPI Number	:	1093650657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATLANTA HO

Provider Business Mailing Address
First Line	:	8075 BEACON LAKE DR STE 600
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8075 BEACON LAKE DR STE 600
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7246
Country	:	US
Telephone Number	:	813-548-2493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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Directions to “ ATLANTA HO ” Practice Location

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