MEDICARE: DIANNA FLOYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	005570	OTHER	CT	LICENSE #

General Provider Information

NPI Number	:	1851400923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA FLOYD

Provider Business Mailing Address
First Line	:	180 BOSTON ST
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437
Country	:	US
Telephone Number	:	203-453-1404
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 DURHAM RD
Second Line	:	OAK PARK PROF COMPLEX STE 14
City	:	MADISON
State	:	CT
Zip	:	06443-2676
Country	:	US
Telephone Number	:	203-245-0001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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Directions to “ DIANNA FLOYD ” Practice Location

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