Provider Demographics
NPI:1780281162
Name:MEDICSLEEP LLC
Entity type:Organization
Organization Name:MEDICSLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:347-573-4721
Mailing Address - Street 1:10479 NW 82ND ST UNIT 14
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4408
Mailing Address - Country:US
Mailing Address - Phone:347-573-4721
Mailing Address - Fax:
Practice Address - Street 1:7842 NW 46TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5461
Practice Address - Country:US
Practice Address - Phone:347-573-4721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty