# ATLANTIC ORTHOPAEDICS, PA

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

## Provider details

- **NPI number:** 1487788824
- **Authorized official:** MRS. SHIRLEY K MUCK (PRACTICE MANAGER)
- **Authorized official phone:** (386) 760-0915

## Contact information

- **Practice address:** 1020 MASON AVE, DAYTONA BEACH, FL 32117
- **Practice address phone:** (386) 760-0915
- **Practice address fax:** (386) 760-0084
- **Mailing address:** 1400 DUNLAWTON AVE STE 1-A, PORT ORANGE, FL 32127-8952
- **Mailing address phone:** (386) 760-0915
- **Mailing address fax:** (386) 760-0084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME0027133 | FL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | ME0044566 | FL | — |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 08/06/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ME0027133 | LISCENSE | FL |
| 01 | — | ME0044566 | LISCENSE | FL |