Healthcare Provider Details

I. General information

NPI: 1821162850
Provider Name (Legal Business Name): SLEEP DISORDER DIAGNOSTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW 35TH AVE STE 203
MIAMI FL
33125-4000
US

IV. Provider business mailing address

600 NW 35TH AVE STE 203
MIAMI FL
33125-4000
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-3724
  • Fax: 305-643-2228
Mailing address:
  • Phone: 305-642-3724
  • Fax: 305-643-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CIRO CALDERON
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-642-3724