MEDICARE: SUNRISE SLEEP CENTER 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1336724574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE SLEEP CENTER LLC

Provider Business Mailing Address
First Line	:	2975 BOBCAT VILLAGE CENTER RD UNIT 200
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-4602
Country	:	US
Telephone Number	:	941-888-2416
Fax Number	:	941-564-6717

Provider Business Practice Location Address
First Line	:	2975 BOBCAT VILLAGE CENTER RD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-4600
Country	:	US
Telephone Number	:	207-460-2887
Fax Number	:

Authorized Official
Title or Position	:	VP/ OWNER
Name	:	CHRISTINA ROBERGE
Credential	:
Telephone Number	:	941-888-2416

Provider Enumeration Date	:	03/09/2021
Last Update Date	:	11/21/2022

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Directions to “SUNRISE SLEEP CENTER LLC ” Practice Location

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