Provider Demographics
NPI:1528102787
Name:FLORIMON, FELIX (MD)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:FLORIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 774
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-0595
Mailing Address - Country:US
Mailing Address - Phone:212-781-0051
Mailing Address - Fax:212-923-5531
Practice Address - Street 1:436 FT WASHINGTN AVE APT 1H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3537
Practice Address - Country:US
Practice Address - Phone:212-781-0051
Practice Address - Fax:212-923-5521
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161092-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00934221Medicaid
NYB17152Medicare UPIN