Provider Demographics
NPI:1326306226
Name:SOMNICARE SLEEP INSTITUTE, PSC
Entity Type:Organization
Organization Name:SOMNICARE SLEEP INSTITUTE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-754-3300
Mailing Address - Street 1:400 AVE DOMENECH STE 407
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3704
Mailing Address - Country:US
Mailing Address - Phone:787-754-3300
Mailing Address - Fax:787-754-4966
Practice Address - Street 1:400 AVE DOMENECH STE 407
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3704
Practice Address - Country:US
Practice Address - Phone:787-754-3300
Practice Address - Fax:787-754-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10527261Q00000X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center