Healthcare Provider Details

I. General information

NPI: 1114738457
Provider Name (Legal Business Name): RESTASSURED SLEEP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 BURNS RD STE 212
PALM BEACH GARDENS FL
33410-4302
US

IV. Provider business mailing address

3365 BURNS RD STE 212
PALM BEACH GARDENS FL
33410-4302
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-9056
  • Fax: 561-625-0910
Mailing address:
  • Phone: 561-627-9056
  • Fax: 561-625-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHARLES ETHEREDGE
Title or Position: OWNER
Credential: DMD
Phone: 561-627-9056