# ATLANTIS CLINIC PA

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

## Provider details

- **NPI number:** 1417957325
- **Authorized official:** DR. HOWARD NELSON CHIPMAN III M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 891-6343

## Contact information

- **Practice address:** 3705 TAMPA RD, \#22, OLDSMAR, FL 34677-6300
- **Practice address phone:** (813) 891-6343
- **Practice address fax:** (813) 891-6342
- **Mailing address:** 3705 TAMPA RD. SUITE 22, OLDSMAR, FL 34677-6346
- **Mailing address phone:** (813) 891-6343
- **Mailing address fax:** (813) 891-6342

## Taxonomy

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

## Other

- **Enumeration date:** 07/21/2005
- **Last updated:** 11/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 257635000 | — | FL |