Healthcare Provider Details

I. General information

NPI: 1467141176
Provider Name (Legal Business Name): WEST COAST SLEEP CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 SEMINOLE BLVD STE 303
LARGO FL
33778-3239
US

IV. Provider business mailing address

11200 SEMINOLE BLVD STE 303
LARGO FL
33778-3239
US

V. Phone/Fax

Practice location:
  • Phone: 727-613-4178
  • Fax: 813-550-1156
Mailing address:
  • Phone: 727-317-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN SCUTERI
Title or Position: PRINCIPAL
Credential: MD
Phone: 727-317-3088