Provider Demographics
NPI:1073566899
Name:SLEEP ASSOCIATES OF FLORIDA LLC
Entity Type:Organization
Organization Name:SLEEP ASSOCIATES OF FLORIDA LLC
Other - Org Name:SLEEP ASSOCIATES OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TECHNICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KURIAKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT RPSGT CPFT
Authorized Official - Phone:813-377-2250
Mailing Address - Street 1:35780 SR 54
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-2242
Mailing Address - Country:US
Mailing Address - Phone:813-377-2250
Mailing Address - Fax:813-283-6853
Practice Address - Street 1:35780 SR 54
Practice Address - Street 2:SUITE 102
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-2242
Practice Address - Country:US
Practice Address - Phone:813-377-2250
Practice Address - Fax:813-283-6853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4207261QS1200X
FLHCC4205261QS1200X
FLHCC4204261QS1200X
FLHCC8377261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC4207OtherHEALTH CARE CLINIC
FLHCC4205OtherHEALTH CARE CLINIC
FLHCC8377OtherHEALTH CARE CLINIC
FLP00050306OtherRAILROAD MEDICARE
FLHCC8545OtherHEALTH CARE CLINIC
FLHCC4204OtherHEALTH CARE CLINIC
FLHCC4205OtherHEALTH CARE CLINIC
X78280Medicare UPIN
FLP00050306Medicare PIN