MEDICARE: FALCON SLEEP CENTER METROWEST

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		FL

General Provider Information

NPI Number	:	1447542626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALCON SLEEP CENTER METROWEST

Provider Business Mailing Address
First Line	:	6000 METROWEST BLVD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-7630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 METROWEST BLVD STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-7630
Country	:	US
Telephone Number	:	407-365-3033
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	AMIN UR REHMAN
Credential	:
Telephone Number	:	407-365-3033

Provider Enumeration Date	:	05/06/2011
Last Update Date	:	06/03/2011

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