Provider Demographics
NPI:1336724574
Name:SUNRISE SLEEP CENTER LLC
Entity Type:Organization
Organization Name:SUNRISE SLEEP CENTER LLC
Other - Org Name:SUNRISE SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-888-2416
Mailing Address - Street 1:2975 BOBCAT VILLAGE CENTER RD UNIT 200
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34288-4602
Mailing Address - Country:US
Mailing Address - Phone:941-888-2416
Mailing Address - Fax:941-564-6717
Practice Address - Street 1:2975 BOBCAT VILLAGE CENTER RD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34288-4600
Practice Address - Country:US
Practice Address - Phone:207-460-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic