Healthcare Provider Details

I. General information

NPI: 1124526405
Provider Name (Legal Business Name): ATLANTIC CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 ALOMA AVE STE 201
WINTER PARK FL
32792-3532
US

IV. Provider business mailing address

2802 ALOMA AVE STE 201
WINTER PARK FL
32792-3532
US

V. Phone/Fax

Practice location:
  • Phone: 407-484-2972
  • Fax: 407-559-8971
Mailing address:
  • Phone: 407-484-2972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: JASON T COONS
Title or Position: OWNER
Credential:
Phone: 407-484-2972