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General NPI Number Information
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NPI Number | 1215706114
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Entity Type | Organization
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Legal Business Name | USA SLEEP DIAGNOSTIC MOBILE SERVICE
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 476 RIVERSIDE AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32202-4912
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Country | US
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Telephone | 888-792-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 6030 DAYBREAK CIR
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1642
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Country | US
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Telephone | 410-804-5424
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Fax | 410-431-3433
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Authorized Official
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Title or Position | MANAGER
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Name | THURLYN BRYAN WILSON
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Credential |
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Telephone | 888-792-4445
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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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