Provider Demographics
NPI:1720016868
Name:SLUTSKY, BRADFORD ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:ADAM
Last Name:SLUTSKY
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 1:1920 US HIGHWAY 441 N
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1922
Mailing Address - Country:US
Mailing Address - Phone:863-763-8100
Mailing Address - Fax:863-763-8669
Practice Address - Street 1:1920 US HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1922
Practice Address - Country:US
Practice Address - Phone:863-763-8100
Practice Address - Fax:863-763-8669
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64131207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 0064131OtherSTATE LICENSE
FL23218ZMedicare PIN
FLME 0064131OtherSTATE LICENSE