Provider Demographics
NPI:1114103918
Name:INNOVATIVE SLEEP SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:INNOVATIVE SLEEP SOLUTIONS, LLC.
Other - Org Name:ISS
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-252-3191
Mailing Address - Street 1:6230 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 7, #343
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4649
Mailing Address - Country:US
Mailing Address - Phone:561-252-3191
Mailing Address - Fax:561-744-2029
Practice Address - Street 1:6230 W INDIANTOWN RD
Practice Address - Street 2:SUITE 7-343
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4649
Practice Address - Country:US
Practice Address - Phone:561-252-3191
Practice Address - Fax:561-744-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN/A261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic