Provider Demographics
NPI:1164844528
Name:CHASE DENTAL SLEEPCARE OF HOLLYWOOD INC.
Entity Type:Organization
Organization Name:CHASE DENTAL SLEEPCARE OF HOLLYWOOD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MALO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-430-3444
Mailing Address - Street 1:2525 EMBASSY DR
Mailing Address - Street 2:#1
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4573
Mailing Address - Country:US
Mailing Address - Phone:954-430-3444
Mailing Address - Fax:954-430-5688
Practice Address - Street 1:2525 EMBASSY DR
Practice Address - Street 2:#1
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-4573
Practice Address - Country:US
Practice Address - Phone:954-430-3444
Practice Address - Fax:954-430-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17046332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment