Healthcare Provider Details

I. General information

NPI: 1427985225
Provider Name (Legal Business Name): SURGICAL & SLEEP SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TREEMONTE DR STE A
ORANGE CITY FL
32763-7978
US

IV. Provider business mailing address

400 TREEMONTE DR STE A
ORANGE CITY FL
32763-7978
US

V. Phone/Fax

Practice location:
  • Phone: 386-837-1236
  • Fax:
Mailing address:
  • Phone: 386-837-1236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHAUNDA ELYSE KELLY
Title or Position: OWNER
Credential:
Phone: 205-514-7390