Provider Demographics
NPI:1760863039
Name:SLEEP DIAGNOSTICS OF CENTRAL FLORIDA, INC
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTICS OF CENTRAL FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR AND BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HILDRETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-273-2675
Mailing Address - Street 1:1401 HERON DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 HERON DR
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2323
Practice Address - Country:US
Practice Address - Phone:407-896-7583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13684261QD0000X, 261QS1200X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment