Provider Demographics
NPI:1235126632
Name:FLOORE, CYNTHIA A (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:FLOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:25245 W SAINT OLAF AVE
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60041-9523
Mailing Address - Country:US
Mailing Address - Phone:847-546-9062
Mailing Address - Fax:847-546-9062
Practice Address - Street 1:2555 N MARTIN LUTHER KING DR
Practice Address - Street 2:MILWAUKEE HEALTH SERVICES, INC.
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2709
Practice Address - Country:US
Practice Address - Phone:414-372-8080
Practice Address - Fax:414-372-7420
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-092051207Q00000X
MI4301082097207Q00000X
WI35825020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN41200004Medicaid
MI08055000111OtherBC/BS MI
MI08055000111OtherBC/BS MI
G36305Medicare UPIN