MEDICARE: WELCOME HOMECARE SLEEP DISORDER CLINICS 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	HCC6490	FL

General Provider Information

NPI Number	:	1831315407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELCOME HOMECARE SLEEP DISORDER CLINICS INC

Provider Business Mailing Address
First Line	:	9570 REGENCY SQUARE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-8100
Country	:	US
Telephone Number	:	904-421-3970
Fax Number	:	904-421-3908

Provider Business Practice Location Address
First Line	:	9570 REGENCY SQUARE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-8100
Country	:	US
Telephone Number	:	904-421-3970
Fax Number	:	904-421-3908

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. THOMAS P. SHOUVLIN
Credential	:
Telephone Number	:	904-421-3944

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	10/13/2009

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