| Brain Spine And Sleep Institute | |
|
1120 Carlton Ave Suite 1300 Lake Wales FL 33853-4347 | |
| (863) 676-6386 | |
| (863) 676-3124 |
| Full Name | Brain Spine And Sleep Institute |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1120 Carlton Ave, Lake Wales, Florida |
| Authorized Official Name and Position | Hasan M Mousli (OWNER/MD) |
| Authorized Official Contact | 8636766386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Spine And Sleep Institute 1120 Carlton Ave Suite 1300 Lake Wales FL 33853-4347 Ph: (863) 676-6386 | Brain Spine And Sleep Institute 1120 Carlton Ave Suite 1300 Lake Wales FL 33853-4347 Ph: (863) 676-6386 |
| NPI Number | 1386190734 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 1153600929 |
|---|---|
| Medicare Enrollment ID | O20161118000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386190734 | NPI | - | NPPES |
| ME97722 | Other | FL | LICENSE |
| Provider Name | Hasan Mousli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710984679 PECOS PAC ID: 3678530631 Enrollment ID: I20070718000500 |
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