| Organization Name: | ATLANTIC DIAGNOSTIC SERVICES, LLC |
| NPI Number: | 1033544630 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN PEREIRA (MANAGING MEMBER) |
| Mailing Address: | 165 W South Street Suite 202 Hernando |
| State: | MS US |
| Postal Code: | 386322266 |
| Phone Number: | 8557176838 |
| Fax Number: | 8883714191 |
| NPI Enumeration Date: | 09/13/2013 |
| NPI Last Update Date: | 01/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |