Provider Demographics
NPI:1295035335
Name:FLORIDA SLEEP & NEURO DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:FLORIDA SLEEP & NEURO DIAGNOSTIC SERVICES INC
Other - Org Name:FSNDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:OTAYEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-370-3100
Mailing Address - Street 1:1755 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3601
Mailing Address - Country:US
Mailing Address - Phone:305-370-3100
Mailing Address - Fax:305-817-8974
Practice Address - Street 1:1755 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3601
Practice Address - Country:US
Practice Address - Phone:305-370-3100
Practice Address - Fax:305-817-8974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
No225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Multi-Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearchGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115810600Medicaid