Provider Demographics
NPI:1649304056
Name:SLOBASKY, MICHAEL SEAN (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SEAN
Last Name:SLOBASKY
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N US HIGHWAY 1 STE 604B
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-3072
Mailing Address - Country:US
Mailing Address - Phone:772-419-9123
Mailing Address - Fax:772-419-9123
Practice Address - Street 1:600 N US HIGHWAY 1 STE 604B
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-3072
Practice Address - Country:US
Practice Address - Phone:772-419-9123
Practice Address - Fax:772-419-9123
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10065208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78291OtherBCBS
FL100344800Medicaid
FL106694600Medicaid