MEDICARE: ATLANTIS CLINIC PA

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	208D00000X	General Practice Physician		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417957325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIS CLINIC PA

Provider Business Mailing Address
First Line	:	3705 TAMPA RD. SUITE 22
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-6346
Country	:	US
Telephone Number	:	813-891-6343
Fax Number	:	813-891-6342

Provider Business Practice Location Address
First Line	:	3705 TAMPA RD
Second Line	:	#22
City	:	OLDSMAR
State	:	FL
Zip	:	34677-6300
Country	:	US
Telephone Number	:	813-891-6343
Fax Number	:	813-891-6342

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HOWARD NELSON CHIPMAN III
Credential	:	M.D.
Telephone Number	:	813-891-6343

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	11/13/2024

Similar Medicare Providers

1417956293 — HOWARD N CHIPMAN III M.D.
Practice Location Address:

3705 TAMPA RD , STE 22
OLDSMAR, FL
34677-6300

Practice Phone: 813-891-6343
Practice Fax: 813-891-6342

1215335948 — TAMPA ROAD PHARMACY
Practice Location Address:

3705 TAMPA RD
OLDSMAR, FL
34677-6300

Practice Phone: 347-816-2198
Practice Fax:

1831886001 — SEAN WORIX PA-C
Practice Location Address:

3705 TAMPA RD
OLDSMAR, FL
34677-6300

Practice Phone: 813-891-6343
Practice Fax: 813-891-6342

1699772681 — JOEL IRA FRANCK MD.
Practice Location Address:

3180 CURLEW ROAD , SUITE 106
OLDSMAR, FL
34677-2629

Practice Phone: 850-778-1547
Practice Fax: 727-286-7738

1497754014 — DR. AMANDA MAN WU M.D.
Practice Location Address:

4028 TAMPA RD
OLDSMAR, FL
34677-3205

Practice Phone: 813-814-9088
Practice Fax: 813-814-9077

1285626762 — JOHN H SHIM MD
Practice Location Address:

309 STATE STREET EAST , SUITE 201
OLDSMAR, FL
34677

Practice Phone: 813-814-9251
Practice Fax: 813-814-9261

Directions to “ATLANTIS CLINIC PA ” Practice Location

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