MEDICARE: DELTA SLEEP SOLUTIONS, CORP

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1144921537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA SLEEP SOLUTIONS, CORP

Provider Business Mailing Address
First Line	:	220 BULLARD PKWY FL 33617
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-5512
Country	:	US
Telephone Number	:	813-443-3235
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 BULLARD PKWY FL 33617
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-5512
Country	:	US
Telephone Number	:	813-443-3235
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUZ CABRERA
Credential	:	DDS
Telephone Number	:	813-443-3235

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	09/05/2024

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