Healthcare Provider Details

I. General information

NPI: 1720016868
Provider Name (Legal Business Name): BRADFORD ADAM SLUTSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 US HIGHWAY 441 N
OKEECHOBEE FL
34972-1922
US

IV. Provider business mailing address

1920 US HIGHWAY 441 N
OKEECHOBEE FL
34972-1922
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-8100
  • Fax: 863-763-8669
Mailing address:
  • Phone: 863-763-8100
  • Fax: 863-763-8669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME64131
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: