Healthcare Provider Details

I. General information

NPI: 1588107445
Provider Name (Legal Business Name): ATLANTIS INTEGRATED MULTISPECIALTY CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 SW 33RD RD SUITE 301
OCALA FL
34474-8470
US

IV. Provider business mailing address

PO BOX 140970
GAINESVILLE FL
32614-0970
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-4602
  • Fax: 352-237-4126
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: GANESH ARORA
Title or Position: PRESIDENT
Credential: PH.D
Phone: 352-861-4602