Organization
C LAWRENCE SLADE MD FACS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MCBRIDE MURPHY (OFFICE MANAGER)
(386) 756-9400
Entity
Organization
Contact information
Practice address
3635 S CLYDE MORRIS BLVD, SUITE 400, PORT ORANGE, FL 32129-2300
(386) 756-9400
(386) 756-4338
Mailing address
3635 S CLYDE MORRIS BLVD, SUITE 400, PORT ORANGE, FL 32129-2300
(386) 756-9400
(386) 756-4338
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME40228
FL
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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