Healthcare Provider Details

I. General information

NPI: 1043269343
Provider Name (Legal Business Name): RODNEY SEVERIN FLOREK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 AMBASSADOR CAFFERY PARKWAY LOURDES RMC
LAFAYETTE LA
70508
US

IV. Provider business mailing address

4801 AMBASSADOR CAFFERY PKWY DEPT OF RADIOLOGY LOURDES RMC
LAFAYETTE LA
70508-6917
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-2180
  • Fax: 337-470-2180
Mailing address:
  • Phone: 337-470-2180
  • Fax: 337-470-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number018207
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: