Healthcare Provider Details

I. General information

NPI: 1104856558
Provider Name (Legal Business Name): AMERICAN SLEEP MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 CRAIG RD STE 101
ST. LOUIS MO
63141-7175
US

IV. Provider business mailing address

7900 BELFORT PKWY STE 301
JACKSONVILLE FL
32256-6978
US

V. Phone/Fax

Practice location:
  • Phone: 314-994-9499
  • Fax: 314-991-6844
Mailing address:
  • Phone: 904-562-5811
  • Fax: 904-517-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN MOCEYUNAS
Title or Position: SERVICE CENTER MANAGER
Credential:
Phone: 904-417-5536