Provider Demographics
NPI:1790774305
Name:UNITED SLEEP DIAGNOSTICS INC
Entity Type:Organization
Organization Name:UNITED SLEEP DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-442-8694
Mailing Address - Street 1:2241 N UNIVERSITY DR STE A
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3609
Mailing Address - Country:US
Mailing Address - Phone:954-442-8694
Mailing Address - Fax:954-442-8695
Practice Address - Street 1:700 N HIATUS RD STE 205
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5206
Practice Address - Country:US
Practice Address - Phone:954-392-4002
Practice Address - Fax:954-442-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5136261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2255Medicare ID - Type Unspecified