1043210651 NPI number — TOTAL SLEEP MANAGEMENT INC

Table of content: (NPI 1043210651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043210651 NPI number — TOTAL SLEEP MANAGEMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL SLEEP MANAGEMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043210651
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1197
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32702-1197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-454-4764
Provider Business Mailing Address Fax Number:
866-601-6965

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1910 N ORANGE AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32804-5552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-441-2411
Provider Business Practice Location Address Fax Number:
800-559-4436
Provider Enumeration Date:
07/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HOLLAND
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
73-194-2314

Provider Taxonomy Codes

  • Taxonomy code: 2084S0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2374548 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7376570 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 116854400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: V2746 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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