Individual
GLENN R SLOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
240 N WICKHAM RD, SUITE 300, MELBOURNE, FL 32935-8662
(321) 308-5050
(321) 984-9497
Mailing address
2222 S HARBOR CITY BLVD, MELBOURNE, FL 32901-5594
(321) 541-1783
(321) 504-0118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DS5906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080077253
RAIL ROAD MEDICARE
—
05
—
371129300
—
FL
Enumeration date
04/12/2006
Last updated
09/18/2014
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