Provider Demographics
NPI:1881747194
Name:ENERE, FLORENCE
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:ENERE
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 1:8 MICHELLE LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1527
Mailing Address - Country:US
Mailing Address - Phone:617-821-5442
Mailing Address - Fax:
Practice Address - Street 1:1515 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3060
Practice Address - Country:US
Practice Address - Phone:781-340-1124
Practice Address - Fax:781-340-5743
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN151796363LF0000X, 363LW0102X
MA151796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0355721Medicaid
MAF648OtherHPHC
MA151796Medicaid
MANP1202OtherBCBS
MA0355721Medicaid