Provider Demographics
NPI:1790949105
Name:SLEEP DISORDER CLINIC PA INC
Entity Type:Organization
Organization Name:SLEEP DISORDER CLINIC PA INC
Other - Org Name:SLEEP DISOREDR CLINIC PA INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOONASAR
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAMPERTAAP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-741-8633
Mailing Address - Street 1:203 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1013
Mailing Address - Country:US
Mailing Address - Phone:941-741-8633
Mailing Address - Fax:941-741-8632
Practice Address - Street 1:203 3RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1013
Practice Address - Country:US
Practice Address - Phone:941-741-8633
Practice Address - Fax:941-741-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053985207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty