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Organization
PEDIM OUTREACH AND SPECIALTY CLINIC LLC
Active
Organization
PEDIM OUTREACH AND SPECIALTY CLINIC LLC
Active
Other names
MHST, SCOFA SLEEPCARE, MD Home Service, MD Sleep Care, SLEEP CLINIC OF AMERICA
Organization subpart
No
Provider details
NPI number
Authorized official
DACELIN ST MARTIN (OWNER)
(352) 527-6888
Entity
Organization
Contact information
Practice address
1982 N PROSPECT AVE, LECANTO, FL 34461-9792
(352) 563-0931
Mailing address
PO BOX 2066, LECANTO, FL 34460-2066
(352) 563-0931
(352) 563-0935
Taxonomy
Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103596200
—
FL
Enumeration date
09/06/2016
Last updated
07/27/2026
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