Provider Demographics
NPI:1770803694
Name:EZ SLEEP DIAGNOSTIC CENTER CORP
Entity type:Organization
Organization Name:EZ SLEEP DIAGNOSTIC CENTER CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-303-1274
Mailing Address - Street 1:10011 PINES BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6167
Mailing Address - Country:US
Mailing Address - Phone:305-303-1274
Mailing Address - Fax:
Practice Address - Street 1:10011 PINES BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6167
Practice Address - Country:US
Practice Address - Phone:305-303-1274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty