Healthcare Provider Details

I. General information

NPI: 1295044899
Provider Name (Legal Business Name): CARDIO SLEEP SOLUTIONS FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 SW 17TH ST
OCALA FL
34471-1224
US

IV. Provider business mailing address

30 ROUTE 18 N
OLD BRIDGE NJ
08857-1420
US

V. Phone/Fax

Practice location:
  • Phone: 352-789-6227
  • Fax:
Mailing address:
  • Phone: 432-254-5999
  • Fax: 732-257-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN15455
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateFL

VIII. Authorized Official

Name: AVI WEISFOGEL
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 732-254-5999