Active NPI
Wilson Florendo
- Other Technician
- Southfield, MI
National Provider Identifier
1316115074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 5501009037
- Practice address
- 29829 Telegraph Rd
Suite 100
Southfield, MI 48034-1330 - Phone
- (248) 355-3033
- Fax
- (248) 355-4936
- NPI assigned
- Feb 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 5501009037 | MI | Primary |
Addresses
Primary practice location
29829 Telegraph Rd
Suite 100
Southfield, MI 48034-1330
Mailing address
29829 Telegraph Rd
Suite 100
Southfield, MI 48034-1330
Phone (248) 355-3033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501009037 | Other | MI | THERAPHY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501009037 | MI | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1316115074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29829 TELEGRAPH RD",
"address_2": "SUITE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341330",
"telephone_number": "248-355-3033",
"fax_number": "248-355-4936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29829 TELEGRAPH RD",
"address_2": "SUITE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341330",
"telephone_number": "248-355-3033",
"fax_number": "248-355-4936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORENDO",
"first_name": "WILSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-15",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MI",
"license": "5501009037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THERAPHY",
"identifier": "5501009037",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.