Provider Demographics
NPI:1659450369
Name:FLOYD, HENRY BASCOM IV (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:BASCOM
Last Name:FLOYD
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3158 TALA LOOP
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3127
Mailing Address - Country:US
Mailing Address - Phone:407-805-8838
Mailing Address - Fax:
Practice Address - Street 1:2151 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5710
Practice Address - Country:US
Practice Address - Phone:407-628-9100
Practice Address - Fax:407-628-0748
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME503272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology