Provider Demographics
NPI:1992191548
Name:ATLANTIC SNORE AND SLEEP APNEA CENTER LLC
Entity Type:Organization
Organization Name:ATLANTIC SNORE AND SLEEP APNEA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-239-7600
Mailing Address - Street 1:1509 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4548
Mailing Address - Country:US
Mailing Address - Phone:386-239-7600
Mailing Address - Fax:866-262-0851
Practice Address - Street 1:1509 MASON AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4548
Practice Address - Country:US
Practice Address - Phone:386-239-7600
Practice Address - Fax:866-262-0851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10669332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment