Provider Demographics
NPI:1194816850
Name:CARDIOHEALTH SLEEP CENTER OF NORTH TAMPA LLC
Entity Type:Organization
Organization Name:CARDIOHEALTH SLEEP CENTER OF NORTH TAMPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN SANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-960-6100
Mailing Address - Street 1:13083 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0926
Mailing Address - Country:US
Mailing Address - Phone:813-960-6100
Mailing Address - Fax:813-960-6144
Practice Address - Street 1:13089 N TELECOM PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-0926
Practice Address - Country:US
Practice Address - Phone:813-977-5337
Practice Address - Fax:813-977-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV3140OtherBCBS PROVIDER #
FLAE423Medicare PIN