Provider Demographics
NPI:1386269348
Name:FLORIDA SLEEP SOLUTIONS OF JAX INC
Entity type:Organization
Organization Name:FLORIDA SLEEP SOLUTIONS OF JAX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:IZURIETA
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:904-718-8018
Mailing Address - Street 1:13453 N MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-2773
Mailing Address - Country:US
Mailing Address - Phone:904-718-8126
Mailing Address - Fax:904-575-4131
Practice Address - Street 1:13453 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-2773
Practice Address - Country:US
Practice Address - Phone:904-683-0687
Practice Address - Fax:904-575-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty