Appointment

Do you need to book an appointment with us for your pulmonary or sleep disorder needs? If so, please submit the intake form, and our office staff will contact you shortly to help facilitate your appointment.

PATIENTS FIRST NAME

PATIENTS LAST NAME

DATE OF BIRTH

EMAIL ADDRESS

PHONE NUMBER

PAST MEDICAL HISTORY

CHOOSE YOUR SERVICE/REASON FOR VISIT

INSURANCE (IF APPLICABLE)

NORTH MIAMI BEACH OFFICE
100NW 170 Street, Suite 301
North Miami Beach, FL 33169
Ph: 305-651-3038
Fax: 305-655-1153

LAUDERDALE LAKES OFFICE
3001 NW 49 Avenue, Suite 202
Lauderdale Lakes, FL 33313
Ph: 954-535-5539
Fax: 954-535-5542

HIALEAH OFFICE
777 East 25 Street, Suite 409
Hialeah, FL 33013
Ph: 305-691-5095
Fax: 305-691-5098