Healthcare Provider Details
I. General information
NPI: 1972576932
Provider Name (Legal Business Name): LIVIU LUCIAN FLORESCU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/09/2006
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8075 SPYGLASS HILL RD SUITE 101
MELBOURNE FL
32940-8281
US
IV. Provider business mailing address
PO BOX 11406
BELFAST ME
04915-4005
US
V. Phone/Fax
- Phone: 321-752-4100
- Fax: 321-752-0307
- Phone: 321-752-4100
- Fax: 321-752-0307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0051519 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: