Provider Demographics
NPI:1508090341
Name:SDR SLEEP & DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:SDR SLEEP & DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-263-6820
Mailing Address - Street 1:836 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3039
Mailing Address - Country:US
Mailing Address - Phone:305-263-6820
Mailing Address - Fax:305-263-6821
Practice Address - Street 1:836 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3039
Practice Address - Country:US
Practice Address - Phone:305-263-6820
Practice Address - Fax:305-263-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic