Healthcare Provider Details
I. General information
NPI: 1871663278
Provider Name (Legal Business Name): MIAMI SLEEP DISORDERS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2006
Last Update Date: 01/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7029 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US
IV. Provider business mailing address
7029 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US
V. Phone/Fax
- Phone: 305-666-2224
- Fax: 305-666-2297
- Phone: 305-666-2224
- Fax: 305-666-2297
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 51163 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ALEJANDRO
CHEDIAK
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 305-666-2224