Provider Demographics
NPI:1366720187
Name:MEDLOCK INSTITUTE FOR SNORING AND SLEEP APNEA, PA.
Entity type:Organization
Organization Name:MEDLOCK INSTITUTE FOR SNORING AND SLEEP APNEA, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-439-4620
Mailing Address - Street 1:2326 S CONGRESS AVE
Mailing Address - Street 2:SUITE 1- D
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7617
Mailing Address - Country:US
Mailing Address - Phone:561-439-4620
Mailing Address - Fax:
Practice Address - Street 1:2326 S CONGRESS AVE
Practice Address - Street 2:SUITE 1- D
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7617
Practice Address - Country:US
Practice Address - Phone:561-439-4620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10346332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment