Healthcare Provider Details

I. General information

NPI: 1619641370
Provider Name (Legal Business Name): MATTHEW MARIUSZ FLORCZYNSKI MSC, MD, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ALBERT SABIN WAY ORTHOPEDIC SPORTS MEDICINE
CINCINNATI OH
45267-5864
US

IV. Provider business mailing address

PO BOX 636256
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8690
  • Fax: 513-475-7257
Mailing address:
  • Phone: 513-585-6200
  • Fax: 513-245-3672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301504277
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35.145789
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: