Provider Demographics
NPI:1205051794
Name:SAINT PETE SLEEP DIAGNOSTICS LLC
Entity type:Organization
Organization Name:SAINT PETE SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-577-2220
Mailing Address - Street 1:750 94TH AVE N
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2453
Mailing Address - Country:US
Mailing Address - Phone:727-577-2220
Mailing Address - Fax:727-577-7230
Practice Address - Street 1:750 94TH AVE N
Practice Address - Street 2:SUITE 208
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2453
Practice Address - Country:US
Practice Address - Phone:727-577-2220
Practice Address - Fax:727-577-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic