L P Slack Medical LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

ME105733 Issued in FL

Legal business name

L P SLACK MEDICAL LLC

Practice address

260 Killarney Bay CT
Winter Park, FL 32789-2907

Phone

(305) 778-7857

NPI assigned

Jun 18, 2011

Organization subpart

No

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

Authorized official

Name

Laura Slack, M.D.

Title

Owner/President

Phone

(305) 778-7857

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308355200000",
    "number": "1437444304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 KILLARNEY BAY CT",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 KILLARNEY BAY CT",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892907",
            "telephone_number": "305-778-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L P SLACK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-18",
        "last_updated": "2011-06-18",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-778-7857",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME105733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joan Kurzon, MD
• Alya Kutik
• Lexi Kuveke
• Ching Kit Kwan, PA-C
• Ernestina Kyei-Donkor, ARNP
• La Esperanza/Hope LLC
• Laboratory Corporation of America
• Labs on the Go
• Lac H Pham,M.D.P.a.
• Prashanta Laddu, MD

• Geriatric Medicine (Internal Medicine) Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2011; 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.