Provider Demographics
NPI:1013984590
Name:BRIONES, FLORANTE L (MD)
Entity Type:Individual
Prefix:
First Name:FLORANTE
Middle Name:L
Last Name:BRIONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6046 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720
Mailing Address - Country:US
Mailing Address - Phone:330-443-1200
Mailing Address - Fax:330-305-5047
Practice Address - Street 1:2500 WALES AVENUE SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646
Practice Address - Country:US
Practice Address - Phone:330-484-2584
Practice Address - Fax:330-484-3529
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9912011OtherMEDICARE GROUP PIN
OH0269203Medicaid
OHBR0380163OtherMEDICARE PTAN
OH0269203Medicaid