Provider Demographics
NPI:1396024329
Name:ADVANCED DIAGNOSTIC SLEEP CENTER CDE INC
Entity Type:Organization
Organization Name:ADVANCED DIAGNOSTIC SLEEP CENTER CDE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-461-0026
Mailing Address - Street 1:7310 W MCNAB RD
Mailing Address - Street 2:105
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5332
Mailing Address - Country:US
Mailing Address - Phone:954-461-0026
Mailing Address - Fax:954-427-7876
Practice Address - Street 1:7310 W MCNAB RD
Practice Address - Street 2:105
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5332
Practice Address - Country:US
Practice Address - Phone:954-461-0026
Practice Address - Fax:954-427-7876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic