Provider Demographics
NPI:1649379637
Name:SOUTHERN SLEEP DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:SOUTHERN SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNERE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-PARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-837-5399
Mailing Address - Street 1:PO BOX 7695
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70010
Mailing Address - Country:US
Mailing Address - Phone:504-837-5399
Mailing Address - Fax:504-837-5366
Practice Address - Street 1:717 FOCIS ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005
Practice Address - Country:US
Practice Address - Phone:504-837-5399
Practice Address - Fax:504-837-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0OtherBCBS
LA=========0OtherBCBS