Provider Demographics
NPI:1801802079
Name:FLORO, JERRY F (MD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:F
Last Name:FLORO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:75 REMITTANCE DR
Mailing Address - Street 2:DEPT 6008
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6008
Mailing Address - Country:US
Mailing Address - Phone:562-282-1419
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5026
Practice Address - Country:US
Practice Address - Phone:562-862-2775
Practice Address - Fax:562-904-8095
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-09-21
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Provider Licenses
StateLicense IDTaxonomies
CAG42959207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA060064763OtherRAILROAD MEDICARE
CA00429590Medicaid
CA00G429590Medicaid
CA00G42959OtherBLUE SHIELD
CA060064763OtherMEDICARE RAILROAD
CA060064763OtherRAILROAD MEDICARE
CA00429590Medicaid