MEDICARE: COMPREHENSIVE SLEEP PULMONARY NEUROLOGY PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RP1001X	Pulmonary Disease Physician
2	2084N0400X	Neurology Physician
3	207R00000X	Internal Medicine Physician
4	207RC0000X	Cardiovascular Disease Physician
5	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1366204679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE SLEEP PULMONARY NEUROLOGY PLLC

Provider Business Mailing Address
First Line	:	2400 NORTH BLVD W STE 1
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-8980
Country	:	US
Telephone Number	:	863-421-5864
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 NORTH BLVD W STE 1
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-8980
Country	:	US
Telephone Number	:	863-421-5864
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. TARIQ BIN IRFAN
Credential	:	MD
Telephone Number	:	863-421-5864

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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