Atlantic Sport & Spine Center LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

ME98460 Issued in FL

Legal business name

ATLANTIC SPORT & SPINE CENTER LLC

Practice address

3 Boulder Rock Dr
Palm Coast, FL 32137-8555

Phone

(386) 445-9444

NPI assigned

Jul 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Michael Sandborn, MD

Title

President

Phone

(386) 445-9444

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1881036697",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SPORT & SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "SANDBORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-445-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "ME98460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.