Provider Demographics
NPI:1790081321
Name:ADVANCED SLEEP AND RESPIRATORY INSTITUTE, P.A.
Entity Type:Organization
Organization Name:ADVANCED SLEEP AND RESPIRATORY INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANY
Authorized Official - Middle Name:A
Authorized Official - Last Name:OBEID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-615-0900
Mailing Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 501
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5170
Mailing Address - Country:US
Mailing Address - Phone:386-615-0900
Mailing Address - Fax:386-615-0902
Practice Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 501
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5170
Practice Address - Country:US
Practice Address - Phone:386-615-0900
Practice Address - Fax:386-615-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-29
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003815901Medicaid