MEDICARE: MINIS MAGNIFICENT LLC

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	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1316826738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINIS MAGNIFICENT LLC

Provider Business Mailing Address
First Line	:	1003 CANDYTUFT CT
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-8607
Country	:	US
Telephone Number	:	615-302-8036
Fax Number	:

Provider Business Practice Location Address
First Line	:	5226 MAIN ST STE D6
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4214
Country	:	US
Telephone Number	:	615-302-8036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SOWMINI OOMMAN
Credential	:
Telephone Number	:	615-302-8039

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	10/30/2025

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Directions to “MINIS MAGNIFICENT LLC ” Practice Location

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