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Organization
FLAGLER DIAGNOSTIC & SLEEPING DISORDER, INC, INC
Active
Organization
FLAGLER DIAGNOSTIC & SLEEPING DISORDER, INC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY L. ROCHES CFE (FACILITY DIRECTOR)
(386) 586-6229
Entity
Organization
Contact information
Practice address
4721 E. MOODY BLVD SUITE 104, BUNNELL, FL 32110
(386) 586-6229
(386) 263-2975
Mailing address
4721 E. MOODY BLVD SUITE 104, BUNNELL, FL 32110
(386) 586-6229
(386) 263-2975
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018211800
—
FL
01
—
P00307040
RAILROAD MEDICARE
FL
01
—
V3019
FL BLUE SHEILD
FL
Enumeration date
10/02/2006
Last updated
03/22/2017
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