Organization
FLAGLER DIAGNOSTIC & SLEEPING DISORDER, INC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG CHEBERKO (OWNER)
(917) 607-1191
Entity
Organization
Contact information
Practice address
1001 W CYPRESS CRK RD STE 104, FORT LAUDERDALE, FL 33309-1947
(954) 306-3760
Mailing address
1001 W CYPRESS CRK RD STE 104, FORT LAUDERDALE, FL 33309-1947
(954) 306-3760
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018211800
—
FL
01
—
8433
AHCA LICENSE
FL
Enumeration date
01/29/2019
Last updated
01/29/2019
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