C. Lawrence Slade, M.D., F.a.C.S., LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME40228 Issued in FL

Legal business name

C. LAWRENCE SLADE, M.D., F.A.C.S., 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

Feb 14, 2012

Organization subpart

No

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

Authorized official

Name

Clement L Slade, M.D.

Title

President

Phone

(386) 756-9400

Specialties & licenses 1

Addresses

Other names 1

• Clement L. Slade, MD Other name

Locations

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1578836003",
    "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, M.D., F.A.C.S., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "SLADE",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-756-9400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME40228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clement L. Slade, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gina Beth Bushelon, DOM, A.P.
• Jay W Butwinick, APRN
• Abiola Byron
• C B Williamson (Halifax Orthopedic Associates)
• C Lawrence Slade MD Facs LLC
• Carlene Cabot
• Rachel Cadigan
• Bryan Thomas Call, D.C.
• Calming Shores Consulting, LLC
• Dena Susan Caltrider, MSPT

• Specialist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.