Healthcare Provider Details
I. General information
NPI: 1053105536
Provider Name (Legal Business Name): ATLANTIC HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5405 OKEECHOBEE BLVD STE 306
WEST PALM BEACH FL
33417-4554
US
IV. Provider business mailing address
5405 OKEECHOBEE BLVD STE 306
WEST PALM BEACH FL
33417-4554
US
V. Phone/Fax
- Phone: 561-855-2816
- Fax: 561-408-3846
- Phone: 561-855-2816
- Fax: 561-406-3846
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HALEY
NEELEY
Title or Position: PRESIDENT
Credential:
Phone: 561-855-2816