MEDICARE: ELIOT SLATER M.D

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	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	ME87458	FL

General Provider Information

NPI Number	:	1447536305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIOT SLATER M.D

Provider Business Mailing Address
First Line	:	2866 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-834-1280
Fax Number	:	954-533-1252

Provider Business Practice Location Address
First Line	:	2866 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-834-1280
Fax Number	:	954-533-1252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	02/12/2018

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