Provider Demographics
NPI:1578656088
Name:SOMNOMEDICS LLC
Entity Type:Organization
Organization Name:SOMNOMEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BUSINESS OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-264-9050
Mailing Address - Street 1:1323 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMP
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:813-264-9050
Mailing Address - Fax:813-319-1127
Practice Address - Street 1:1101 W. HIBISCUS BLVD
Practice Address - Street 2:#100
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:813-264-9050
Practice Address - Fax:813-319-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5480291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory