Provider Demographics
NPI:1699216515
Name:FLORIDA SLEEP SOLUTIONS INC
Entity type:Organization
Organization Name:FLORIDA SLEEP SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:IZURIETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RPSGT
Authorized Official - Phone:904-718-8018
Mailing Address - Street 1:13453 N MAIN ST STE 202
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:904-683-0687
Mailing Address - Fax:904-575-4131
Practice Address - Street 1:13453 N MAIN ST STE 202
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?:Yes
Parent Organization LBN:FLORIDA SLEEP SOLUTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10359261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic