ATLANTIC SPORT & SPINE CENTER NPI 1316388978

NPI Information

NPI: 1316388978
Provider Name: ATLANTIC SPORT & SPINE CENTER
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 10D1030197

Address:
3 BOULDER ROCK DR
PALM COAST, FL
ZIP 32137
Phone: (386) 445-9444
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ATLANTIC SPORT & SPINE CENTER is a multi-specialty clinic center in Palm Coast, FL. ATLANTIC SPORT & SPINE CENTER NPI is 1316388978. The provider is registered as an organization entity type.

The provider's business location address is:

3 BOULDER ROCK DR
PALM COAST, FL
ZIP 32137-555
Phone: (386) 445-9444
Fax: (386) 446-2971

The provider's authorized official is Michael G Sandborn .
The authorized official title is Medical Director and has the following contact phone number (386) 445-9444.

The CLIA number assigned to this NPI record is 10D1030197 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2013 and was last updated on 7/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	HCC9168	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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