Atlantic Medical Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ATLANTIC MEDICAL SERVICES, LLC

Practice address

1690 Dunlawton Ave Ste 210
Port Orange, FL 32127-8980

Phone

(386) 763-4920

Fax

(386) 763-4939

NPI assigned

Jan 31, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ammar Hemaidan, M.D.

Title

Representative of Member

Phone

(386) 763-4920

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1659643120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AVE STE 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AVE STE 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "HEMAIDAN",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_title_or_position": "REPRESENTATIVE OF MEMBER",
        "authorized_official_telephone_number": "386-763-4920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.