Provider Demographics
NPI:1376278176
Name:BLUESLEEP FLORIDA LLC
Entity Type:Organization
Organization Name:BLUESLEEP FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-209-3979
Mailing Address - Street 1:15 BROAD ST APT 2414
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1989
Mailing Address - Country:US
Mailing Address - Phone:646-209-3979
Mailing Address - Fax:
Practice Address - Street 1:10075 JOG RD, #309
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3343
Practice Address - Country:US
Practice Address - Phone:646-813-0645
Practice Address - Fax:646-731-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty