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Organization

POLK SLEEP DISORDERS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY DANIELS (OWNER)
(863) 299-0302
Entity
Organization

Contact information

Practice address
35 LAKE ELBERT DR., WINTER HAVEN, FL 33880-3058
(863) 299-0302
(863) 299-0370
Mailing address
PO BOX 7272, WINTER HAVEN, FL 33883-7272
(863) 299-0302
(863) 299-0370

Taxonomy

Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00389765
MEDICARE RAILROAD
01
V3161
BC FL
FL
Enumeration date
05/25/2006
Last updated
07/29/2014
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