Provider Demographics
NPI:1043023054
Name:BREATHE SLEEP CENTER, LLC
Entity type:Organization
Organization Name:BREATHE SLEEP CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ELIKOFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-568-1195
Mailing Address - Street 1:4312 W EL PRADO BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8440
Mailing Address - Country:US
Mailing Address - Phone:813-831-8588
Mailing Address - Fax:813-831-7036
Practice Address - Street 1:4312 W EL PRADO BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8440
Practice Address - Country:US
Practice Address - Phone:813-831-8588
Practice Address - Fax:813-831-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment