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Organization
ATLANTIC ORTHOPAEDICS, PA
Active
Organization
ATLANTIC ORTHOPAEDICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY K MUCK (PRACTICE MANAGER)
(386) 760-0915
Entity
Organization
Contact information
Practice address
1020 MASON AVE, DAYTONA BEACH, FL 32117
(386) 760-0915
(386) 760-0084
Mailing address
1400 DUNLAWTON AVE STE 1-A, PORT ORANGE, FL 32127-8952
(386) 760-0915
(386) 760-0084
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0027133
FL
207X00000X
Orthopaedic Surgery Physician
ME0044566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME0027133
LISCENSE
FL
01
—
ME0044566
LISCENSE
FL
Enumeration date
03/16/2007
Last updated
08/06/2010
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