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General NPI Number Information
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NPI Number | 1003389024
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Entity Type | Organization
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Legal Business Name | SOUTHEAST SNORING & SLEEP APNEA GROUP
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 108 PENNACLES DR. #101
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City | PALM COAST
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State | FL
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Zip | 32164
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Country | US
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Telephone | 904-657-1374
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Fax | 888-299-7250
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Provider Business Mailing Address
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Address Line | 108 PENNACLES DR. #101
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City | PALM COAST
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State | FL
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Zip | 32164
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Country | US
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Telephone | 904-657-1374
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Fax | 888-299-7250
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Authorized Official
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Title or Position | MANAGER
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Name | DONNA SHELDON
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Credential |
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Telephone | 904-657-1374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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