Provider Demographics
NPI:1558464768
Name:SLOVIK, SEAN TODD (OTR/L, LMT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:TODD
Last Name:SLOVIK
Suffix:
Gender:M
Credentials:OTR/L, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S PATRICK DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3804
Mailing Address - Country:US
Mailing Address - Phone:321-426-8756
Mailing Address - Fax:
Practice Address - Street 1:704 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3804
Practice Address - Country:US
Practice Address - Phone:321-426-8756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38170225700000X
FLOT13217225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2165OtherBCBS