Provider Demographics
NPI:1184839029
Name:SLEEP MEDICINE SPECIALISTS OF SOUTHWEST FL P.A.
Entity Type:Organization
Organization Name:SLEEP MEDICINE SPECIALISTS OF SOUTHWEST FL P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:J. MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-218-5226
Mailing Address - Street 1:10201 ARCOS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928
Mailing Address - Country:US
Mailing Address - Phone:239-390-3190
Mailing Address - Fax:239-390-3191
Practice Address - Street 1:10201 ARCOS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928
Practice Address - Country:US
Practice Address - Phone:239-390-3190
Practice Address - Fax:239-390-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty