MEDICARE: NORTH FLORIDA SLEEP RESOURCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1033835723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH FLORIDA SLEEP RESOURCES

Provider Business Mailing Address
First Line	:	1700 EAGLE HARBOR PKWY STE 7
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8329
Country	:	US
Telephone Number	:	904-906-6007
Fax Number	:	904-280-6658

Provider Business Practice Location Address
First Line	:	1700 EAGLE HARBOR PKWY STE 7
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8329
Country	:	US
Telephone Number	:	904-906-6007
Fax Number	:	904-280-6658

Authorized Official
Title or Position	:	DENTIST
Name	:	KELLY STANDISH-MAYO
Credential	:	DMD
Telephone Number	:	904-505-3311

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	04/06/2026

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Directions to “NORTH FLORIDA SLEEP RESOURCES ” Practice Location

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