Provider Demographics
NPI:1821432386
Name:SLEEPMANATEE, PL
Entity Type:Organization
Organization Name:SLEEPMANATEE, PL
Other - Org Name:DAVID E LAW SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-792-8383
Mailing Address - Street 1:5517 21ST AVE W
Mailing Address - Street 2:STE F
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5604
Mailing Address - Country:US
Mailing Address - Phone:941-792-8383
Mailing Address - Fax:941-792-8484
Practice Address - Street 1:5517 21ST AVE W
Practice Address - Street 2:STE F
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5604
Practice Address - Country:US
Practice Address - Phone:941-792-8383
Practice Address - Fax:941-792-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39816174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC75984Medicare UPIN