Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | OS-5506 | FL |
NPI | 1194825620 |
---|---|
Provider Name | Dr. Raymond Ambrose Sleszynski JR. |
First Address | St Petersburg, FL 33715-2019 |
Second Address | Tampa, FL 33609-4056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 08/07/2007 |