Healthcare Provider Details

I. General information

NPI: 1336071174
Provider Name (Legal Business Name): SLEEP NEURO MOBILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1782 W FLAGLER ST
MIAMI FL
33135-2017
US

IV. Provider business mailing address

1782 W FLAGLER ST
MIAMI FL
33135-2017
US

V. Phone/Fax

Practice location:
  • Phone: 616-432-0985
  • Fax: 305-998-4963
Mailing address:
  • Phone: 616-432-0985
  • Fax: 305-998-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIO A HERRERA
Title or Position: MGR
Credential:
Phone: 616-432-0985