Provider Demographics
NPI:1134118524
Name:NERI, FLORENCIO PASCUAL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORENCIO
Middle Name:PASCUAL
Last Name:NERI
Suffix:JR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:702 STAFFORD DR
Mailing Address - Street 2:PO BOX 5394
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2406
Mailing Address - Country:US
Mailing Address - Phone:304-425-0085
Mailing Address - Fax:304-425-6283
Practice Address - Street 1:702 STAFFORD DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2406
Practice Address - Country:US
Practice Address - Phone:304-425-0085
Practice Address - Fax:304-487-6993
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2010-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV11431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVD10010811OtherRR MEDICARE
001710002OtherMT ST
213442OtherCARELINK
WV1326813OtherFUNDS
WV0055660000Medicaid
001710002OtherMT ST
C35003Medicare UPIN