Provider Demographics
NPI:1134266794
Name:UNIVERSAL SLEEP DISORDER CENTERS INC
Entity type:Organization
Organization Name:UNIVERSAL SLEEP DISORDER CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-903-9399
Mailing Address - Street 1:6900 TURKEY LAKE RD
Mailing Address - Street 2:SUITE 1-1
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4707
Mailing Address - Country:US
Mailing Address - Phone:407-903-9399
Mailing Address - Fax:407-370-9784
Practice Address - Street 1:6900 TURKEY LAKE RD
Practice Address - Street 2:SUITE 1-1
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4707
Practice Address - Country:US
Practice Address - Phone:407-903-9399
Practice Address - Fax:407-370-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75691207RS0012X
261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6967Medicare ID - Type UnspecifiedMEDICARE NUMBER