Healthcare Provider Details
I. General information
NPI: 1740757111
Provider Name (Legal Business Name): HEALTHY SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2018
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 LEE RD STE B
WINTER PARK FL
32789-1871
US
IV. Provider business mailing address
2001 LEE RD STE B
WINTER PARK FL
32789-1871
US
V. Phone/Fax
- Phone: 407-645-4741
- Fax:
- Phone: 407-645-4741
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUIS
G.
ACOSTA
Title or Position: MANAGER
Credential: DMD
Phone: 407-645-4741