Basic Information
Provider Information
NPI: 1780830562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLORIN
FirstName: LAUREN
MiddleName: AIMEE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 125 METRO CENTER BLVD STE 2000
Address2:  
City: WARWICK
State: RI
PostalCode: 028861768
CountryCode: US
TelephoneNumber: 4014322520
FaxNumber: 4014538220
Practice Location
Address1: 125 METRO CENTER BLVD STE 200
Address2:  
City: WARWICK
State: RI
PostalCode: 028861768
CountryCode: US
TelephoneNumber: 4014322520
FaxNumber: 4014538220
Other Information
ProviderEnumerationDate: 08/13/2008
LastUpdateDate: 03/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700XMD13533RIN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085N0700X239061MAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085R0202XMD13533RIY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X239061MAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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