Provider Demographics
NPI:1043269343
Name:FLOREK, RODNEY SEVERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:SEVERIN
Last Name:FLOREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:DEPT OF RADIOLOGY LOURDES RMC
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6917
Mailing Address - Country:US
Mailing Address - Phone:337-470-2180
Mailing Address - Fax:337-470-7447
Practice Address - Street 1:4801 AMBASSADOR CAFFERY PARKWAY
Practice Address - Street 2:LOURDES RMC
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-470-2180
Practice Address - Fax:337-470-2180
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0182072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1928445Medicaid
LAP00906564OtherRAILROAD MEDICARE
MS03480216Medicaid
LAP00906564OtherRAILROAD MEDICARE
LA5R025DG58Medicare PIN
LA1928445Medicaid
300034039Medicare ID - Type UnspecifiedRAILROAD