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General NPI Number Information
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NPI Number | 1053504043
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Entity Type | Organization
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Legal Business Name | SLEEP EASY GULF COAST SLEEP DIAGNOSTIC CENTER LLC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 2475 E NINE MILE RD SUITE F
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City | PENSACOLA
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State | FL
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Zip | 32514-7795
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Country | US
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Telephone | 850-607-7293
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Fax | 850-607-7321
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Provider Business Mailing Address
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Address Line | PO BOX 6370
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City | PENSACOLA
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State | FL
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Zip | 32503-0370
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Country | US
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Telephone | 850-607-7293
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Fax | 850-607-7321
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | STUART H. BROWN
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Credential |
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Telephone | 850-607-7293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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