Provider Demographics
NPI:1548241524
Name:SLONIM, ROBERTA R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:R
Last Name:SLONIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 BRICKELL AVE
Mailing Address - Street 2:STE 1801
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1240
Mailing Address - Country:US
Mailing Address - Phone:305-858-8156
Mailing Address - Fax:
Practice Address - Street 1:1533 SUNSET DR
Practice Address - Street 2:STE 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33143-5700
Practice Address - Country:US
Practice Address - Phone:305-740-7887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10142207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90608Medicare ID - Type Unspecified
D86422Medicare UPIN