Healthcare Provider Details

I. General information

NPI: 1821280579
Provider Name (Legal Business Name): ATLANTIS URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH FL
32937-4922
US

IV. Provider business mailing address

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH FL
32937-4922
US

V. Phone/Fax

Practice location:
  • Phone: 321-777-2273
  • Fax: 321-779-7425
Mailing address:
  • Phone: 321-777-2273
  • Fax: 321-779-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number602309
License Number StateFL

VIII. Authorized Official

Name: DR. BJORN DIMBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 321-777-2273