Provider Demographics
NPI:1669232716
Name:OWN SLEEP MEDICINE SERVICES LLC
Entity type:Organization
Organization Name:OWN SLEEP MEDICINE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:CLINT
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-777-1069
Mailing Address - Street 1:360 CENTRAL AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3984
Mailing Address - Country:US
Mailing Address - Phone:833-777-1069
Mailing Address - Fax:833-777-2969
Practice Address - Street 1:360 CENTRAL AVE STE 800
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3984
Practice Address - Country:US
Practice Address - Phone:833-777-1069
Practice Address - Fax:833-777-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic