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General NPI Number Information
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NPI Number | 1770803694
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Entity Type | Organization
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Legal Business Name | EZ SLEEP DIAGNOSTIC CENTER CORP
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 08/07/2011
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Provider Practice Location Address
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Address Line | 10011 PINES BLVD STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6167
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Country | US
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Telephone | 305-303-1274
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Fax |
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Provider Business Mailing Address
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Address Line | 10011 PINES BLVD STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6167
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Country | US
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Telephone | 305-303-1274
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MS. DEENA WEISS
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Credential | LCSW
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Telephone | 305-303-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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