Basic Information
| Provider Information | |||||||||
| NPI: | 1811979636 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLOMKA | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7993 10TH AVE S0 | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274586703 | ||||||||
| FaxNumber: | 7273443048 | ||||||||
| Practice Location | |||||||||
| Address1: | 6500 66TH ST | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337815030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273471286 | ||||||||
| FaxNumber: | 7273453084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2005 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | ME21558 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 044568100 | 05 | FL | MEDICAID | 255859 | 01 | FL | AVMED | OTHER | 4511661 | 01 | FL | AETNA | OTHER | 200009549 | 01 | RAILROAD MEDICARE | OTHER | 52626 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |