MEDICARE: COMMUNITY SLEEP DISORDERS CENTERS OF AMERICA, INC.

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	4740	FL

General Provider Information

NPI Number	:	1104156868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SLEEP DISORDERS CENTERS OF AMERICA, INC.

Provider Business Mailing Address
First Line	:	PO BOX 161533
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32716-1533
Country	:	US
Telephone Number	:	352-637-5599
Fax Number	:	352-637-5564

Provider Business Practice Location Address
First Line	:	2224 HIGHWAY 44 W
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3860
Country	:	US
Telephone Number	:	352-637-5599
Fax Number	:	352-637-5567

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN C. WILLIAMS
Credential	:
Telephone Number	:	407-497-0994

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

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