C Lawrence Slade MD Facs LLC

NPI #1043520554 in Port Orange, Florida

Provider Information

NPI Number: 1043520554
Entity Type: Organization
Organization Name: C Lawrence Slade MD Facs LLC
Primary Specialty: Plastic Surgery
Enumeration Date: Oct 18, 2010
Last Updated: Oct 18, 2010

Practice Location

Address: 3635 S CLYDE MORRIS BLVD
Address 2: SUITE 400
City: Port Orange
State: Florida
ZIP Code: 32129-2300
Phone: (386) 756-9400

Authorized Official

Name: MS. SUSAN MCBRIDE MURPHY
Title: OFFICE MANAGER
Phone: (386) 756-9400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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