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General NPI Number Information
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NPI Number | 1639473911
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Entity Type | Organization
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Legal Business Name | SOMNOCARE,LLC
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 6333 SUNSET DR SUITE B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4822
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Country | US
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Telephone | 305-763-8407
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Fax | 305-424-9194
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Provider Business Mailing Address
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Address Line | 6333 SUNSET DR SUITE B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4822
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Country | US
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Telephone | 305-763-8407
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Fax | 305-424-9194
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN CARLOS MEDINA
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Credential | RPSGT
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Telephone | 305-763-8407
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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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