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MS. HEATHER CATHERINE SLAYTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
507 DEL PRADO BLVD S, CAPE CORAL, FL 33990-2618
(239) 772-0500
(239) 772-3076
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-2030
(239) 343-4116

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106900
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019027900
FL
01
1107510
NCCPA
FL
01
13887932
CAQH PROVIDER ID
FL
01
1649523143
NPI
FL
01
1951623826
MEDICARE PECOS ID
FL
01
363A00000X
MEDICARE TAXONOMY ID
FL
01
4850001
AETNA
FL
01
5023117
CIGNA
FL
01
5QI08
BCBS
FL
01
I20141203001730
MEDICARE ENROLLMENT ID
FL
01
P01771721
RR MEDICARE
FL
01
P1045436
FREEDOM
FL
01
P978877
OPTIMUM
FL
01
PA9106900
FL DOH PA LICENSE
FL
Enumeration date
10/22/2012
Last updated
03/30/2021
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