# ATLANTIS CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033959051
- **Authorized official:** HOWARD NELSON CHIPMAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 476-2321

## Contact information

- **Practice address:** 1530 4TH ST N, ST PETERSBURG, FL 33704-4412
- **Practice address phone:** (727) 821-8700
- **Practice address fax:** (727) 821-8770
- **Mailing address:** 1530 4TH ST N, ST PETERSBURG, FL 33704-4412
- **Mailing address phone:** (727) 821-8700
- **Mailing address fax:** (727) 821-8770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/28/2024
- **Last updated:** 05/28/2024