Provider Demographics
NPI:1538564315
Name:DENTON, SLOANE MATHIS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SLOANE
Middle Name:MATHIS
Last Name:DENTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SLOANE
Other - Middle Name:
Other - Last Name:MATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:721 GREENWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801
Mailing Address - Country:US
Mailing Address - Phone:850-207-7914
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4659
Practice Address - Country:US
Practice Address - Phone:321-732-7774
Practice Address - Fax:321-732-7773
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant