Provider Demographics
NPI:1043221005
Name:SLONE, FREDERICK LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:LOUIS
Last Name:SLONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3808
Mailing Address - Country:US
Mailing Address - Phone:813-251-1838
Mailing Address - Fax:
Practice Address - Street 1:552 RIVIERA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3808
Practice Address - Country:US
Practice Address - Phone:813-251-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0035710207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58845Medicare UPIN
FL79569Medicare ID - Type Unspecified