Provider Demographics
NPI:1508864539
Name:BERO, FLORENCE C (MD)
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:C
Last Name:BERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:80 E MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1450
Mailing Address - Country:US
Mailing Address - Phone:315-386-8184
Mailing Address - Fax:315-386-2804
Practice Address - Street 1:80 E MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1450
Practice Address - Country:US
Practice Address - Phone:315-386-8184
Practice Address - Fax:315-386-2804
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD423753207Q00000X
NY228388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101109466Medicaid
PA080288Medicare ID - Type Unspecified