SPACE COAST SLEEP DISORDERS CENTER LLC NPI 1023037272

NPI Information

NPI: 1023037272
Provider Name: SPACE COAST SLEEP DISORDERS CENTER LLC
Classification: Clinic/Center - 261QS1200X
Entity Type: Organization

Specialization: Sleep Disorder Diagnostic

Address:
640 CLASSIC CT
SUITE 106
MELBOURNE, FL
ZIP 32940
Phone: (321) 255-9901
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SPACE COAST SLEEP DISORDERS CENTER LLC is a sleep disorder diagnostic clinic center in Melbourne, FL. SPACE COAST SLEEP DISORDERS CENTER LLC NPI is 1023037272. The provider is registered as an organization entity type.

The provider's business location address is:

640 CLASSIC CT
SUITE 106
MELBOURNE, FL
ZIP 32940-279
Phone: (321) 255-9901
Fax: (321) 255-9902

The provider's authorized official is Antonio Edwin Stigall .
The authorized official title is President/ceo and has the following contact phone number (321) 255-9901.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 2/28/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS1200X	Clinic/Center	Sleep Disorder Diagnostic	HCC7135	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	FLORIDA	GREAT WEST
2	=========	OTHER	FLORIDA	UNITED HEALTH CARE
3	F301267	OTHER	FLORIDA	FREEDOM HEALTH
4	36521	OTHER	FLORIDA	WELLCARE
5	=========	OTHER	FLORIDA	HUMANA
6	IV937A	MEDICARE UPIN	FLORIDA
7	01092537	OTHER	FLORIDA	AMERI GROUP
8	1065447	OTHER	FLORIDA	CARE PLUS
9	=========	OTHER	FLORIDA	TRICARE
10	=========	OTHER	FLORIDA	CIGNA
11	7729847	OTHER	FLORIDA	AETNA
12	V3120	OTHER	FLORIDA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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