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General NPI Number Information
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NPI Number | 1417378753
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Entity Type | Organization
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Legal Business Name | GAINESVILLE SLEEP LAB, LLC
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 1834 SW 1ST AVE SUITE 301
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City | OCALA
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State | FL
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Zip | 34471-8100
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Country | US
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Telephone | 352-671-9924
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Fax | 352-671-9925
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Provider Business Mailing Address
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Address Line | 1834 SW 1ST AVE SUITE 301
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City | OCALA
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State | FL
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Zip | 34471-8100
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Country | US
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Telephone | 352-671-9924
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Fax | 352-671-9925
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Authorized Official
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Title or Position | OWNER / ADMINISTRATIVE DIRECTOR
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Name | MS. FRAN E EVANS
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Credential | RRT,RST,RPSGT
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Telephone | 352-671-9924
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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 | HCC9175
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License Number State | FL
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