Healthcare Provider Details

I. General information

NPI: 1700441102
Provider Name (Legal Business Name): MICHAEL VICTOR FLORIE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WASHINGTON AVE SE
MINNEAPOLIS MN
55414-2904
US

IV. Provider business mailing address

720 WASHINGTON AVE SE
MINNEAPOLIS MN
55414-2924
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1450
  • Fax:
Mailing address:
  • Phone: 860-917-6037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number309923
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1110
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: