Provider Demographics
NPI:1609096460
Name:EDWARD J. FLOYD DPM
Entity Type:Organization
Organization Name:EDWARD J. FLOYD DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-442-3113
Mailing Address - Street 1:6551 WILSON MILLS RD
Mailing Address - Street 2:STE 104
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3495
Mailing Address - Country:US
Mailing Address - Phone:440-442-3113
Mailing Address - Fax:440-442-5137
Practice Address - Street 1:6551 WILSON MILLS RD
Practice Address - Street 2:STE 104
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-3495
Practice Address - Country:US
Practice Address - Phone:440-442-3113
Practice Address - Fax:440-442-5137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2314034Medicaid
OHCG2818OtherRAILROAD MEDICARE
OH=========00OtherOHIO BWC
OHU62299Medicare UPIN
OH2314034Medicaid
OH0803450001Medicare NSC
OH9302251Medicare PIN