Provider Demographics
NPI:1467422659
Name:PLOUS, OREN (MD)
Entity Type:Individual
Prefix:
First Name:OREN
Middle Name:
Last Name:PLOUS
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 1:1961 FLOYD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2931
Mailing Address - Country:US
Mailing Address - Phone:941-312-2769
Mailing Address - Fax:866-426-2169
Practice Address - Street 1:1961 FLOYD ST
Practice Address - Street 2:SUITE B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-312-2769
Practice Address - Fax:941-759-6476
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97145207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93115OtherBCBS
FLP01531788OtherPALMETTO GBA-RAILROAD MEDICARE
FL91135OtherBC
FL277086500Medicaid
FLP01531788OtherPALMETTO GBA-RAILROAD MEDICARE
FL91135OtherBC
FLP01406413OtherPALMETTO GBA RAILROAD MCR
FLAB951XMedicare PIN
FLAB951OMedicare PIN
FLAB951NMedicare PIN
I02547Medicare UPIN
FLAB951TMedicare PIN