Healthcare Provider Details

I. General information

NPI: 1407693658
Provider Name (Legal Business Name): ATLAS HEALTH SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 SW 72ND ST STE 116
MIAMI FL
33173-3245
US

IV. Provider business mailing address

1463 SW 146TH CT
MIAMI FL
33184-3260
US

V. Phone/Fax

Practice location:
  • Phone: 305-430-5709
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CESAR REMON CASTILLO
Title or Position: OWNER
Credential:
Phone: 305-430-5709