Provider Demographics
NPI:1093854507
Name:FLORIO, JANICE HARE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:HARE
Last Name:FLORIO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3605 W BEACH DR
Mailing Address - Street 2:
Mailing Address - City:OAK ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28465-7842
Mailing Address - Country:US
Mailing Address - Phone:910-454-9001
Mailing Address - Fax:910-454-4039
Practice Address - Street 1:5083 SOUTHPORT SUPPLY RD SE
Practice Address - Street 2:UNIT 4
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8155
Practice Address - Country:US
Practice Address - Phone:910-454-9001
Practice Address - Fax:910-454-4039
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2929225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211567Medicaid
NC7301535Medicaid
NC133V5OtherBLUE CROSS BLUE SHIELD