Provider Demographics
NPI:1144523127
Name:BAPTIST SLEEP CENTER AT GALLOWAY
Entity type:Organization
Organization Name:BAPTIST SLEEP CENTER AT GALLOWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTA-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:6855 RED ROAD
Mailing Address - Street 2:STE 500
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3623
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:786-533-9403
Practice Address - Street 1:7400 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5458
Practice Address - Country:US
Practice Address - Phone:786-662-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST SLEEP CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-13
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3276770OtherUNITED
PVN-8286558OtherAETNA HMO
34-00159OtherUNITED MEDICARE
PIN-9784775OtherAETNA NON HMO
FL003909400Medicaid
342866OtherAVMED
F00327677001OtherNEIGHORHOOD
=========OtherJMH HEALTH PLAN
=========OtherHUMANA CHOICE
FL003909400Medicaid
=========OtherDIMENSION
F00327677001OtherNEIGHORHOOD
PIN-9784775OtherAETNA NON HMO
342866OtherAVMED
=========OtherCIGNA
=========OtherCORVEL
=========OtherDIMENSION