Healthcare Provider Details

I. General information

NPI: 1417293192
Provider Name (Legal Business Name): ATROYPEN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N STATE ROAD 7 SUITE 408
LAUDERDALE LAKES FL
33319-5600
US

IV. Provider business mailing address

3500 N STATE ROAD 7 SUITE 408
LAUDERDALE LAKES FL
33319-5600
US

V. Phone/Fax

Practice location:
  • Phone: 786-468-3296
  • Fax:
Mailing address:
  • Phone: 786-468-3296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI B BRYANT
Title or Position: OWNER
Credential:
Phone: 786-468-3296