Healthcare Provider Details

I. General information

NPI: 1043210651
Provider Name (Legal Business Name): TOTAL SLEEP MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 N ORANGE AVE SUITE 2
ORLANDO FL
32804-5552
US

IV. Provider business mailing address

PO BOX 1197
ALTOONA FL
32702-1197
US

V. Phone/Fax

Practice location:
  • Phone: 877-441-2411
  • Fax: 800-559-4436
Mailing address:
  • Phone: 407-454-4764
  • Fax: 866-601-6965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICHOLAS HOLLAND
Title or Position: VP
Credential: BSBA
Phone: 73-194-2314