Provider Demographics
NPI:1477809424
Name:NEUROSCIENCE AND SLEEP DISORDERS CENTER
Entity Type:Organization
Organization Name:NEUROSCIENCE AND SLEEP DISORDERS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARAIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-777-2680
Mailing Address - Street 1:PO BOX 2315
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34991-7315
Mailing Address - Country:US
Mailing Address - Phone:772-777-2680
Mailing Address - Fax:772-777-2684
Practice Address - Street 1:1405 SE GOLDTREE DR
Practice Address - Street 2:SUITE B
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7563
Practice Address - Country:US
Practice Address - Phone:772-777-2680
Practice Address - Fax:772-777-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty