Organization
ATLANTIC PSYCHIATRIC, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDI D WIDMAIER (OFFICE MANAGER)
(386) 304-3444
Entity
Organization
Contact information
Practice address
719 BEVILLE RD, SOUTH DAYTONA, FL 32119-1823
(386) 304-3444
(386) 304-3403
Mailing address
PO BOX 290849, PORT ORANGE, FL 32129-0849
(386) 304-3444
(386) 304-3403
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME56967
FL
Other
Enumeration date
02/22/2007
Last updated
08/22/2020
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