MEDICARE: SLEEP APNEA INSTITUTE OF SARASOTA 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	261QD0000X	Dental Clinic/Center	DN15542	FL

General Provider Information

NPI Number	:	1649648627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP APNEA INSTITUTE OF SARASOTA INC

Provider Business Mailing Address
First Line	:	1419 BURGOS DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-2705
Country	:	US
Telephone Number	:	941-539-9718
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 N WASHINGTON BLVD STE B
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-4253
Country	:	US
Telephone Number	:	941-955-7344
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. JAMES T. CANNON
Credential	:	D.M.D
Telephone Number	:	941-539-9718

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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