Atlantic Sport & Spine Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

HCC9168 Issued in FL

Legal business name

ATLANTIC SPORT & SPINE CENTER

Practice address

3 Boulder Rock Dr
Palm Coast, FL 32137-8555

Phone

(386) 445-9444

Fax

(386) 446-2971

NPI assigned

Jul 11, 2013

Last updated

Jul 11, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael G Sandborn, MD

Title

Medical Director

Phone

(386) 445-9444

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1316388978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BOULDER ROCK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378555",
            "telephone_number": "386-445-9444",
            "fax_number": "386-446-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BOULDER ROCK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378555",
            "telephone_number": "386-445-9444",
            "fax_number": "386-446-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SPORT & SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "SANDBORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "386-445-9444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "HCC9168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlantic Dental Arts LLC
• Atlantic Nutrition Centers, LLC
• Atlantic Podiatry Associates DPM PA
• Atlantic Podiatry Associates DPM PA
• Atlantic Rides LLC
• Atlantic Sport & Spine Center LLC
• Atlantic Urological Associates P a
• Atlantic Urological Associates P a
• Atlas Behavioral Health, PA
• Saa'Fiyah Austin

• Multi-Specialty Clinic/Center in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.