Healthcare Provider Details

I. General information

NPI: 1225906217
Provider Name (Legal Business Name): ATLANTIC CARE SERVICES PPEC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 ALOMA AVE STE 100
WINTER PARK FL
32792-3532
US

IV. Provider business mailing address

2802 ALOMA AVE STE 100
WINTER PARK FL
32792-3532
US

V. Phone/Fax

Practice location:
  • Phone: 407-270-5501
  • Fax: 407-559-8971
Mailing address:
  • Phone: 407-270-5501
  • Fax: 407-559-8971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: KARLA RODRIGUEZ BASURTO
Title or Position: DIRECTOR
Credential:
Phone: 407-270-5501