Provider Demographics
NPI:1407179179
Name:VILLAGE SLEEP LAB & BREATHING CENTER INC
Entity Type:Organization
Organization Name:VILLAGE SLEEP LAB & BREATHING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-751-4955
Mailing Address - Street 1:1400 N US HIGHWAY 441 STE 942
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6813
Mailing Address - Country:US
Mailing Address - Phone:352-751-4955
Mailing Address - Fax:888-716-2004
Practice Address - Street 1:1400 N US HIGHWAY 441 STE 942
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6813
Practice Address - Country:US
Practice Address - Phone:352-751-4955
Practice Address - Fax:888-716-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0081374207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty