Healthcare Provider Details

I. General information

NPI: 1902614860
Provider Name (Legal Business Name): GUY MERVYN SLOWIK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2024
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 GOLF CLUB LN
TAMPA FL
33618-2707
US

IV. Provider business mailing address

4308 GOLF CLUB LN
TAMPA FL
33618-2707
US

V. Phone/Fax

Practice location:
  • Phone: 813-420-8020
  • Fax:
Mailing address:
  • Phone: 813-420-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number201417
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number201417
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: