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Physician Compare National (NPI:1447330808)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1447330808
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 7517993470
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20050712000629
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name FLORO
Individual professional last name
Provider First Name MARIANO
Individual professional first name
Provider Middle Name N
Individual professional middle name
Provider Name Suffix Text JR.
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1958
Individual professional's medical school graduation year
Primary Specialty GENERAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 VASCULAR SURGERY
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties VASCULAR SURGERY
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 2880 NETHERTON DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 101
Group Practice or individual's line 2 address
City SAINT LOUIS
Group Practice or individual's city
State MO
Group Practice or individual's state
Zip Code 631364697
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 260180
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 CHRISTIAN HOSPITAL NORTHEAST
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment M

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