Healthcare Provider Details

I. General information

NPI: 1487260295
Provider Name (Legal Business Name): JUST BREATH SLEEP DENTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 CYPRESS PKWY
KISSIMMEE FL
34759-3328
US

IV. Provider business mailing address

1096 CYPRESS PKWY
KISSIMMEE FL
34759-3328
US

V. Phone/Fax

Practice location:
  • Phone: 407-973-8286
  • Fax:
Mailing address:
  • Phone: 407-973-8286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. MONICA LILIANA VARELA
Title or Position: DENTIST
Credential: DDS
Phone: 407-473-5615