Individual
DR. SLAVITA MARIA LAIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
632 DEL PRADO BLVD N STE 1, CAPE CORAL, FL 33909-2278
(239) 468-8076
(239) 468-7938
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 468-8076
(239) 468-7938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A145021
CA
207R00000X
Internal Medicine Physician
MD171761
OR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME122906
FL
208M00000X
Hospitalist Physician
MD171761
OR
390200000X
Student in an Organized Health Care Education/Training Program
MD2020-0591
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124222700
—
FL
01
—
MD171761
OREGON LICENSE
OR
Enumeration date
07/05/2012
Last updated
11/21/2024
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