Provider Demographics
NPI:1508811639
Name:NIELSEN, FLORIN REX JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORIN
Middle Name:REX
Last Name:NIELSEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:F.
Other - Middle Name:REX
Other - Last Name:NIELSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:280 N HOSPITAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4216
Mailing Address - Country:US
Mailing Address - Phone:435-637-3098
Mailing Address - Fax:435-637-8656
Practice Address - Street 1:280 N HOSPITAL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4216
Practice Address - Country:US
Practice Address - Phone:435-637-3098
Practice Address - Fax:435-637-8656
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT272238-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT87-0527339OtherFEDERAL TAX ID #
UTF86792Medicare UPIN
UT000011298Medicare ID - Type Unspecified