MEDICARE: ATLANTIC MEDICAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH7081	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6828710001	OTHER	FL	DME

General Provider Information

NPI Number	:	1477896090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC MEDICAL, INC

Provider Business Mailing Address
First Line	:	934 N UNIVERSITY DR
Second Line	:	#237
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7029
Country	:	US
Telephone Number	:	954-800-7091
Fax Number	:	954-800-7092

Provider Business Practice Location Address
First Line	:	10414 W ATLANTIC BLVD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5605
Country	:	US
Telephone Number	:	954-800-7091
Fax Number	:	954-800-7092

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GREGG POPKIN
Credential	:	D.C.
Telephone Number	:	954-800-7091

Provider Enumeration Date	:	04/02/2013
Last Update Date	:	07/16/2014

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