Provider Demographics
NPI:1619487600
Name:FLOORE, CATINA DEMETRIS
Entity Type:Individual
Prefix:
First Name:CATINA
Middle Name:DEMETRIS
Last Name:FLOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 GROSS AVE
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62205-3017
Mailing Address - Country:US
Mailing Address - Phone:618-979-4581
Mailing Address - Fax:618-979-4581
Practice Address - Street 1:1333 GROSS AVE
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62205-3017
Practice Address - Country:US
Practice Address - Phone:618-979-4581
Practice Address - Fax:618-979-4581
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)