Provider Demographics
NPI:1295044899
Name:CARDIO SLEEP SOLUTIONS FLORIDA
Entity Type:Organization
Organization Name:CARDIO SLEEP SOLUTIONS FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISFOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-254-5999
Mailing Address - Street 1:30 ROUTE 18 N
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1420
Mailing Address - Country:US
Mailing Address - Phone:432-254-5999
Mailing Address - Fax:732-257-5606
Practice Address - Street 1:1609 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1224
Practice Address - Country:US
Practice Address - Phone:352-789-6227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15455122300000X
FL332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6472980001Medicare NSC