Healthcare Provider Details

I. General information

NPI: 1235162884
Provider Name (Legal Business Name): KEVIN MARK SLAWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9511 COLLINS AVE APT 1403
SURFSIDE FL
33154-2660
US

IV. Provider business mailing address

9511 COLLINS AVE APT 1403
SURFSIDE FL
33154-2660
US

V. Phone/Fax

Practice location:
  • Phone: 713-299-1776
  • Fax: 305-675-3972
Mailing address:
  • Phone: 713-299-1776
  • Fax: 305-675-3972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberJ3225
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME137855
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: