MEDICARE: FLORIDA SLEEP SOLUTIONS 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	HCC10359	FL

General Provider Information

NPI Number	:	1699216515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA SLEEP SOLUTIONS INC

Provider Business Mailing Address
First Line	:	13453 N MAIN ST STE 202
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-2773
Country	:	US
Telephone Number	:	904-683-0687
Fax Number	:	904-575-4131

Provider Business Practice Location Address
First Line	:	13453 N MAIN ST STE 202
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-2773
Country	:	US
Telephone Number	:	904-683-0687
Fax Number	:	904-575-4131

Authorized Official
Title or Position	:	VICEPRESIDENT
Name	:	DR. JUAN CARLOS IZURIETA
Credential	:	MD, RPSGT
Telephone Number	:	904-718-8018

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	03/10/2017

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Directions to “FLORIDA SLEEP SOLUTIONS INC ” Practice Location

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