Organization
ATLANTIC HEALTH MSO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE DAVILA HASTINGS (PRESIDENT)
(305) 363-2886
Entity
Organization
Contact information
Practice address
8785 SW 165TH AVE STE 200-2014, MIAMI, FL 33193-5826
(305) 363-2886
Mailing address
8785 SW 165TH AVE STE 200-2014, MIAMI, FL 33193-5826
(305) 363-2886
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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