Provider Demographics
NPI:1043085251
Name:FLAGLER DIAGNOSTIC AND SLEEPING DISORDER, INC.
Entity Type:Organization
Organization Name:FLAGLER DIAGNOSTIC AND SLEEPING DISORDER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEBERKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-586-6229
Mailing Address - Street 1:1001 W CYPRESS CREEK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 W CYPRESS CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1947
Practice Address - Country:US
Practice Address - Phone:386-586-6229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic