Organization
BRAIN SPINE AND SLEEP INSTITUTE LLC
Active
Other names
Brain Spine and Sleep Institute
Organization subpart
No
Provider details
NPI number
Authorized official
HASAN M MOUSLI MD (OWNER/MD)
(863) 676-6386
Entity
Organization
Contact information
Practice address
1120 CARLTON AVE, SUITE 1300, LAKE WALES, FL 33853-4347
(863) 676-6386
(863) 676-3124
Mailing address
1120 CARLTON AVE, SUITE 1300, LAKE WALES, FL 33853-4347
(863) 676-6386
(863) 676-3124
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME97722
LICENSE
FL
Enumeration date
08/26/2016
Last updated
03/07/2023
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