Organization
NORTHWEST FLORIDA SLEEP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BOOLE MD (PRESIDENT)
(850) 889-4550
Entity
Organization
Contact information
Practice address
310 RACETRACK RD NW, SUITE 200, FORT WALTON BEACH, FL 32547-1553
(850) 889-4550
Mailing address
214 LAFITTE CRES, FORT WALTON BEACH, FL 32547-3293
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
ME96773
FL
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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