Provider Demographics
NPI:1700589405
Name:DRAHOS SLEEP LLC
Entity Type:Organization
Organization Name:DRAHOS SLEEP LLC
Other - Org Name:PREMIER SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAHOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-676-1789
Mailing Address - Street 1:PO BOX 941455
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-1455
Mailing Address - Country:US
Mailing Address - Phone:407-243-8782
Mailing Address - Fax:
Practice Address - Street 1:161 S BOYD ST STE 120
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3574
Practice Address - Country:US
Practice Address - Phone:407-573-5733
Practice Address - Fax:407-573-5491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Single Specialty