Provider Demographics
NPI:1851441356
Name:OLDER & SLONIM MD'S PA
Entity Type:Organization
Organization Name:OLDER & SLONIM MD'S PA
Other - Org Name:J. JUSTIN OLDER EYELID INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-971-3846
Mailing Address - Street 1:4444 E FLETCHER AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4905
Mailing Address - Country:US
Mailing Address - Phone:813-971-3846
Mailing Address - Fax:813-977-2611
Practice Address - Street 1:4444 E FLETCHER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-971-3846
Practice Address - Fax:813-977-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21356207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38934OtherBCBS GROUP PAYEE #
FLK1253Medicare ID - Type UnspecifiedGROUP #