Healthcare Provider Details

I. General information

NPI: 1104154525
Provider Name (Legal Business Name): ATLANTIC DIAGNOSTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E SAMPLE RD SUITE E6
POMPANO BEACH FL
33064-5161
US

IV. Provider business mailing address

1001 E SAMPLE RD SUITE E6
POMPANO BEACH FL
33064-5161
US

V. Phone/Fax

Practice location:
  • Phone: 954-703-9380
  • Fax:
Mailing address:
  • Phone: 954-703-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: PETER A TURCO
Title or Position: PRESIDENT
Credential:
Phone: 954-703-9380