Provider Demographics
NPI:1427152537
Name:CENTRAL FLORIDA PEDIATRIC SLEEP DISORDERS INSTITUTE, PA
Entity type:Organization
Organization Name:CENTRAL FLORIDA PEDIATRIC SLEEP DISORDERS INSTITUTE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AKINYEMI
Authorized Official - Middle Name:OLUTOYE
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:407-898-2767
Mailing Address - Street 1:6I5 EAST PRINCETON STREET
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803
Mailing Address - Country:US
Mailing Address - Phone:407-898-2767
Mailing Address - Fax:407-898-9443
Practice Address - Street 1:6I5 EAST PRINCETON STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-898-2767
Practice Address - Fax:407-898-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51483ZMedicare ID - Type Unspecified