Provider Demographics
NPI:1164856233
Name:SLEEP DISORDER SPECIALISTS PLLC
Entity Type:Organization
Organization Name:SLEEP DISORDER SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-252-6763
Mailing Address - Street 1:655 S APOLLO BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1485
Mailing Address - Country:US
Mailing Address - Phone:321-327-2440
Mailing Address - Fax:
Practice Address - Street 1:655 S APOLLO BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1485
Practice Address - Country:US
Practice Address - Phone:321-327-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL168151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty