Provider Demographics
NPI:1225482359
Name:SLEEPY KIDZZZ CSP
Entity Type:Organization
Organization Name:SLEEPY KIDZZZ CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OTTO
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALDAHONDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-309-1123
Mailing Address - Street 1:PO BOX 367471
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7471
Mailing Address - Country:US
Mailing Address - Phone:787-309-1123
Mailing Address - Fax:
Practice Address - Street 1:381 AVE FELISA RINCON DE GAUTIER APT 1503
Practice Address - Street 2:COND PASEOMONTE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6665
Practice Address - Country:US
Practice Address - Phone:787-309-1123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR167402080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty