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General NPI Number Information
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NPI Number | 1760208557
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Entity Type | Organization
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Legal Business Name | ATLAS PHYSICAL FITNESS
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 854 S DUNCAN DR
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City | TAVARES
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State | FL
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Zip | 32778-4044
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Country | US
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Telephone | 352-205-6147
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Fax | 352-306-0571
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Provider Business Mailing Address
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Address Line | 1011 RIVIERA DR
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City | LEESBURG
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State | FL
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Zip | 34748-6741
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Country | US
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Telephone | 352-205-6147
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELMER BRIGNONI
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Credential | DPT
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Telephone | 352-205-6147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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