Healthcare Provider Details

I. General information

NPI: 1184780793
Provider Name (Legal Business Name): SYLVIA A. FLORIAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYLVIA A. BROOKS

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 BOND AVE
EAST SAINT LOUIS IL
62207-2328
US

IV. Provider business mailing address

6000 BOND AVE
EAST SAINT LOUIS IL
62207-2328
US

V. Phone/Fax

Practice location:
  • Phone: 618-332-2740
  • Fax: 618-332-8755
Mailing address:
  • Phone: 618-332-2740
  • Fax: 618-332-8755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041285806
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number064549
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209001652
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number064549
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: