Organization Name: | POLK SLEEP DISORDERS LLC |
NPI Number: | 1023064011 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY DANIELS (OWNER) |
Mailing Address: | 35 Lake Elbert Dr. Winter Haven |
State: | FL US |
Postal Code: | 338803058 |
Phone Number: | 8632990302 |
Fax Number: | 8632990370 |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 07/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |