Provider Demographics
NPI:1316217243
Name:ANDREW E. SLATKOW, P.A.
Entity Type:Organization
Organization Name:ANDREW E. SLATKOW, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLATKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-943-6336
Mailing Address - Street 1:4510 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6509
Mailing Address - Country:US
Mailing Address - Phone:954-943-6336
Mailing Address - Fax:
Practice Address - Street 1:4510 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6509
Practice Address - Country:US
Practice Address - Phone:954-943-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88699Medicare PIN