FOUNTAIN OF YOUTH MD LLC
NPI 1649527284
General Practice in Atlanta, GA

Q: What is Fountain Of Youth MD LLC's NPI number?

The NPI number for Fountain Of Youth MD LLC is 1649527284. It was assigned to this organization in the NPPES registry on August 14, 2012.

Q: What is Fountain Of Youth MD LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since August 14, 2012

200 GALLERIA PKWY SE, SUITE 100, ATLANTA, GA 30339(770) 695-5500(800) 814-3301 Get Directions Write a Review

NPPES record last updated: May 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fountain Of Youth Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOUNTAIN OF YOUTH MD LLC (NPI 1649527284) is a healthcare organization registered as a general practice in Atlanta, Georgia and active in the NPI registry since August 2012. The organization lists Offer Danan, Owner, as its authorized official.

NPPES Registry Identity

NPI1649527284

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameFOUNTAIN OF YOUTH MD LLC

Location Address200 GALLERIA PKWY SE, SUITE 100Atlanta, GA 30339-5918

Mailing Address200 Galleria Pkwy Se, Suite 100Atlanta, GA 30339-5918 · (770) 695-5500 · Fax (800) 814-3301

Phone(770) 695-5500

Fax(800) 814-3301

Organization SubpartNo

Authorized OfficialOffer DananOwner · (770) 695-5500

Enumeration DateAugust 14, 2012

Last NPPES UpdateMay 22, 2014

✔ NPI 1649527284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

200 GALLERIA PKWY SE, Atlanta, GA 30339

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTER FOR COSMETIC & RECONSTRUCTIVE SURGERY PC

Plastic Surgery

200 GALLERIA PKWY SE, SUITE 590
ATLANTA, GA 30339

Cobb County (770) 951-7595

ANITA VADRIA

Physician Assistant

200 GALLERIA PKWY SE, SUITE 100
ATLANTA, GA 30339

Cobb County (770) 444-0076

RESTORE HEALTH GROUP, INC

Rehabilitation Hospital

200 GALLERIA PKWY SE, SUITE 1800
ATLANTA, GA 30339

Cobb County (678) 277-9275

DR. HEMA JITENDRA HEBBAR O.D

Optometrist

200 GALLERIA PKWY SE, SUITE 200
ATLANTA, GA 30339

Cobb County (770) 955-3938

LCA-VISION

Clinic/Center (Ophthalmologic Surgery)

200 GALLERIA PKWY SE, SUITE 200
ATLANTA, GA 30339

Cobb County (770) 955-3938

DR. ROSS STEVEN LEVINE D.M.D.

Dentist (General Practice)

200 GALLERIA PKWY SE, SUITE 1830
ATLANTA, GA 30339

Cobb County (770) 356-2493

FOUNTAIN OF YOUTH MD, LLC

Durable Medical Equipment & Medical Supplies

200 GALLERIA PKWY SE, 100
ATLANTA, GA 30339

Cobb County (404) 382-9277

KRYSTAL ALLEN FNP-C

Nurse Practitioner (Family)

200 GALLERIA PKWY SE
ATLANTA, GA 30339

Cobb County (800) 893-9698

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fountain Of Youth MD LLC's NPI number?

The NPI number for Fountain Of Youth MD LLC is 1649527284. It was assigned to this organization in the NPPES registry on August 14, 2012.

Where is Fountain Of Youth MD LLC located?

Fountain Of Youth MD LLC is located at 200 Galleria Pkwy SE Suite 100, Atlanta, GA 30339. The listed phone number is (770) 695-5500.

What is Fountain Of Youth MD LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Fountain Of Youth MD LLC was last updated on May 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.