Provider Demographics
NPI:1053498675
Name:SLEEP DISORDER CENTER INC
Entity Type:Organization
Organization Name:SLEEP DISORDER CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:P
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-443-9223
Mailing Address - Street 1:145 MADEIRA AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4520
Mailing Address - Country:US
Mailing Address - Phone:305-443-9223
Mailing Address - Fax:305-443-9225
Practice Address - Street 1:145 MADEIRA AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4520
Practice Address - Country:US
Practice Address - Phone:305-443-9223
Practice Address - Fax:305-443-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7320261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic