Provider Demographics
NPI:1033835723
Name:NORTH FLORIDA SLEEP RESOURCES
Entity Type:Organization
Organization Name:NORTH FLORIDA SLEEP RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANDISH-MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:904-505-3311
Mailing Address - Street 1:1700 EAGLE HARBOR PKWY
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-8329
Mailing Address - Country:US
Mailing Address - Phone:904-906-6007
Mailing Address - Fax:904-280-6658
Practice Address - Street 1:1700 EAGLE HARBOR PKWY
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-8329
Practice Address - Country:US
Practice Address - Phone:904-906-6007
Practice Address - Fax:904-280-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty