Provider Demographics
NPI:1982750634
Name:FLORIO, MARK GREGORY (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:GREGORY
Last Name:FLORIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6991 W BROWARD BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2907
Mailing Address - Country:US
Mailing Address - Phone:954-791-3300
Mailing Address - Fax:
Practice Address - Street 1:6991 W BROWARD BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2907
Practice Address - Country:US
Practice Address - Phone:954-791-3300
Practice Address - Fax:954-791-3300
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2622213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEH756AMedicare PIN
FLE3306Medicare PIN
FLU72114Medicare UPIN
E3306YMedicare PIN
FLE3306ZMedicare PIN