Individual provider Active NPI

Florencio Vinalon Llacuna Jr., MD

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1710047733
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05807300 Issued in NJ
Practice address
1100 Clifton Avenue
Clifton, NJ 07013
Phone
(973) 594-8444
Fax
(973) 773-4491
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05807300 NJ Primary

Addresses

Primary practice location

1100 Clifton Avenue
Clifton, NJ 07013

Mailing address

1100 Clifton Avenue
Clifton, NJ 07013
Phone (973) 594-8444

Other identifiers 1

IdentifierTypeStateIssuer
5598109MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622000043 NJ Practitioner - Internal Medicine 5294770194 Practice locations: Clifton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 Clifton Ave
Clifton, NJ 07013-3631
Phone (973) 812-1879

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Clifton, NJ, CCN 317017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05807300NJMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: florenciollacuna@ermd.allscriptsdirect.net

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710047733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLIFTON AVENUE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "973-594-8444",
            "fax_number": "973-773-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLIFTON AVENUE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "973-594-8444",
            "fax_number": "973-773-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLACUNA",
        "first_name": "FLORENCIO",
        "middle_name": "VINALON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05807300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5598109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.