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General NPI Number Information
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NPI Number | 1821432386
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Entity Type | Organization
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Legal Business Name | SLEEPMANATEE, PL
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 5517 21ST AVE W STE F
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City | BRADENTON
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State | FL
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Zip | 34209-5604
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Country | US
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Telephone | 941-792-8383
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Fax | 941-792-8484
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Provider Business Mailing Address
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Address Line | 5517 21ST AVE W STE F
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City | BRADENTON
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State | FL
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Zip | 34209-5604
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Country | US
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Telephone | 941-792-8383
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Fax | 941-792-8484
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Authorized Official
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Title or Position | OWNER
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Name | DAVID E LAW
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Credential | MD
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Telephone | 941-792-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME39816
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License Number State | FL
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