MEDICARE: SOUTH FLORIDA OTOLARYNGOLOGY ASSOCIATES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	ME60166	FL

General Provider Information

NPI Number	:	1336354307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA OTOLARYNGOLOGY ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	3015 S CONGRESS AVE
Second Line	:	SUITE 6
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2111
Country	:	US
Telephone Number	:	561-966-9611
Fax Number	:	561-966-4160

Provider Business Practice Location Address
First Line	:	3015 S CONGRESS AVE
Second Line	:	SUITE 6
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2111
Country	:	US
Telephone Number	:	561-966-9611
Fax Number	:	561-966-4160

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM STUART SLOMKA
Credential	:	MD
Telephone Number	:	561-966-4100

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	08/22/2020

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