1730443268 NPI number — SUMMIT CLINICAL DIAGNOSTIC GROUP LLC

Table of content: ALISON LINDON SLONE M.D. (NPI 1669730867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730443268 NPI number — SUMMIT CLINICAL DIAGNOSTIC GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUMMIT CLINICAL DIAGNOSTIC GROUP LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730443268
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11140 NORTH KENDALL DRIVE
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-546-3637
Provider Business Mailing Address Fax Number:
305-274-4549

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11140 N. KENDALL DR.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-546-3637
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINS
Authorized Official First Name:
JOAO
Authorized Official Middle Name:
CARLOS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-274-4501

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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