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General NPI Number Information
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NPI Number | 1164165676
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Entity Type | Organization
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Legal Business Name | SAN MARCUS SLEEP LAB LLC
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 5941 NW 173RD DR UNIT 1
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City | HIALEAH
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State | FL
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Zip | 33015-5110
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Country | US
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Telephone | 786-953-6020
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Fax | 305-701-4101
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Provider Business Mailing Address
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Address Line | 5941 NW 173RD DR UNIT 1
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City | HIALEAH
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State | FL
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Zip | 33015-5110
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Country | US
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Telephone | 786-953-6020
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Fax | 305-701-4101
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Authorized Official
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Title or Position | SLEEP CENTER MANAGER
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Name | BEATRIZ GONI
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Credential |
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Telephone | 305-987-1515
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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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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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