Provider Demographics
NPI:1457306417
Name:LOYA, FLORENTINO NONONG (MD)
Entity Type:Individual
Prefix:
First Name:FLORENTINO
Middle Name:NONONG
Last Name:LOYA
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 1:6400 MARLBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2841
Mailing Address - Country:US
Mailing Address - Phone:301-736-7000
Mailing Address - Fax:301-736-6916
Practice Address - Street 1:6400 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2841
Practice Address - Country:US
Practice Address - Phone:301-736-7000
Practice Address - Fax:301-736-6916
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD005933R99Medicare ID - Type Unspecified
MDF33177Medicare UPIN