Healthcare Provider Details

I. General information

NPI: 1477587111
Provider Name (Legal Business Name): IN YOUR DREAMS INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 MAR WALT DR SUITE 2021
FORT WALTON BEACH FL
32547
US

IV. Provider business mailing address

99 ROSEWOOD DR STE 245
DANVERS MA
01923-4537
US

V. Phone/Fax

Practice location:
  • Phone: 850-863-0006
  • Fax: 850-863-0012
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA NAUFUL
Title or Position: VP COMPLIANCE & CONTRACTING
Credential:
Phone: 770-309-2000