Provider Demographics
NPI:1982639696
Name:SLEEP WELL MED, INC
Entity Type:Organization
Organization Name:SLEEP WELL MED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAHBA
Authorized Official - Middle Name:WADIE
Authorized Official - Last Name:WAHBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-257-2363
Mailing Address - Street 1:810 WILDWOOD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4568
Mailing Address - Country:US
Mailing Address - Phone:386-257-2363
Mailing Address - Fax:386-258-7102
Practice Address - Street 1:810 WILDWOOD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4568
Practice Address - Country:US
Practice Address - Phone:386-257-2363
Practice Address - Fax:386-258-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042004261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0228Medicare ID - Type Unspecified