MEDICARE: SLEEP DIAGNOSTICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	445	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023190444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP DIAGNOSTICS, INC

Provider Business Mailing Address
First Line	:	1910 N ORANGE AVE
Second Line	:	SUITE B
City	:	ORLANDO
State	:	FL
Zip	:	32804-5528
Country	:	US
Telephone Number	:	407-894-6998
Fax Number	:	407-896-4242

Provider Business Practice Location Address
First Line	:	1966 W NEW HAMPSHIRE ST
Second Line	:	SUITE E
City	:	ORLANDO
State	:	FL
Zip	:	32804-6024
Country	:	US
Telephone Number	:	407-894-6998
Fax Number	:	407-896-4242

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KIRK TAYLOR BANKS
Credential	:
Telephone Number	:	407-894-6998

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	06/08/2012

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