NPIMap

Organization Active NPI

C Lawrence Slade MD Facs LLC

  • Plastic Surgery Physician
  • Port Orange, FL
National Provider Identifier
1043520554
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME40228 Issued in FL
Legal business name
C LAWRENCE SLADE MD FACS LLC
Practice address
3635 S Clyde Morris Blvd
Suite 400
Port Orange, FL 32129-2300
Phone
(386) 756-9400
Fax
(386) 756-4338
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Susan McBride Murphy
Title
Office Manager
Phone
(386) 756-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X ME40228 FL Primary

Addresses

Primary practice location

3635 S Clyde Morris Blvd
Suite 400
Port Orange, FL 32129-2300

Mailing address

3635 S Clyde Morris Blvd
Suite 400
Port Orange, FL 32129-2300
Phone (386) 756-9400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1043520554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 S CLYDE MORRIS BLVD",
            "address_2": "SUITE 400",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292300",
            "telephone_number": "386-756-9400",
            "fax_number": "386-756-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 S CLYDE MORRIS BLVD",
            "address_2": "SUITE 400",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292300",
            "telephone_number": "386-756-9400",
            "fax_number": "386-756-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C LAWRENCE SLADE MD FACS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MCBRIDE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-756-9400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME40228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.