Healthcare Provider Details
I. General information
NPI: 1780827683
Provider Name (Legal Business Name): MICHAEL SLOBASKY DO PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2009
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 SW MARTIN DOWNS BLVD STE 300
PALM CITY FL
34990-2861
US
IV. Provider business mailing address
901 SW MARTIN DOWNS BLVD STE 300
PALM CITY FL
34990-2861
US
V. Phone/Fax
- Phone: 800-735-1178
- Fax: 772-223-6354
- Phone: 800-735-1178
- Fax: 772-223-6354
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
SLOBASKY
Title or Position: CEO
Credential: DO
Phone: 215-869-8777