Provider Demographics
NPI:1437686185
Name:PROACT SLEEP DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:PROACT SLEEP DIAGNOSTICS, INC.
Other - Org Name:PROACT HEALTH SOLUTIONS, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-974-9111
Mailing Address - Street 1:2940 MALLORY CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1818
Mailing Address - Country:US
Mailing Address - Phone:800-570-7414
Mailing Address - Fax:407-507-2608
Practice Address - Street 1:2940 MALLORY CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-1818
Practice Address - Country:US
Practice Address - Phone:800-570-7414
Practice Address - Fax:407-507-2608
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROACT HEALTH SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic