1982738738 NPI number — CENTER FOR SLEEP AND LUNG DISORDERS INC

Table of content: (NPI 1982738738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982738738 NPI number — CENTER FOR SLEEP AND LUNG DISORDERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR SLEEP AND LUNG DISORDERS 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:
1982738738
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1480
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADY LAKE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32158-1480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-391-5500
Provider Business Mailing Address Fax Number:
352-391-5501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
918 ROLLING ACRES RD STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LADY LAKE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32159-5026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-391-5500
Provider Business Practice Location Address Fax Number:
352-391-5501
Provider Enumeration Date:
03/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UPADYA
Authorized Official First Name:
ANUPAMA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
352-552-5685

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  97830 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1200X , with the licence number: 97830 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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