MEDICARE: TRINITY SLEEP SOLUTIONS LLC

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	HCC7322	FL

General Provider Information

NPI Number	:	1972674711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY SLEEP SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4128 ROWAN RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-6122
Country	:	US
Telephone Number	:	727-232-3948
Fax Number	:	727-232-3956

Provider Business Practice Location Address
First Line	:	4128 ROWAN RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-6122
Country	:	US
Telephone Number	:	727-232-3948
Fax Number	:	727-232-3956

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MELISSA S EVANS
Credential	:
Telephone Number	:	727-232-3948

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	01/30/2008

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