Organization
ATLANTIC COVE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLINS EZEUKA MD (CEO, CMO, FOUNDER)
(941) 208-3070
Entity
Organization
Contact information
Practice address
22141 VENTURA BLVD STE 300, WOODLAND HILLS, CA 91364-5734
(941) 208-3070
(941) 208-3070
Mailing address
5342 CLARK RD # 3072, SARASOTA, FL 34233-3227
(941) 208-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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