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General NPI Number Information
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NPI Number | 1376155069
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Entity Type | Organization
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Legal Business Name | ATLAS SPORTS REHABILITATION SERVICES LLC
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Dates
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Enumeration Date | 08/23/2020
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 8715 STIRLING RD
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City | COOPER CITY
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State | FL
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Zip | 33328-5932
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Country | US
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Telephone | 954-900-3484
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Fax | 954-408-1597
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Provider Business Mailing Address
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Address Line | 10171 NW 3RD ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3971
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MARJAN CVETKOVIC
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Credential | PT
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Telephone | 954-900-3484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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