Organization
ATLANTIC ENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PAUL WIDICK M.D. (SOLE MBR)
(321) 799-9797
Entity
Organization
Contact information
Practice address
333 W COCOA BEACH CSWY STE B, COCOA BEACH, FL 32931-3513
(321) 799-9797
(321) 799-3393
Mailing address
333 W COCOA BEACH CSWY STE B, COCOA BEACH, FL 32931-3513
(321) 799-9797
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
ME0061454
FL
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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