Individual provider Active NPI

Andrew I Florentino, M.D.

  • Pediatrics Physician
  • Lynwood, CA
National Provider Identifier
1780796763
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A50125 Issued in CA
Practice address
3585 E. Imperial Hwy
Lynwood, CA 90262
Phone
(310) 605-4260
Fax
(310) 605-4263
NPI assigned
Aug 31, 2006
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A50125 CA
Pediatrics Physician 208000000X A50125 CA Primary

Addresses

Primary practice location

3585 E. Imperial Hwy
Lynwood, CA 90262

Mailing address

3585 E. Imperial Hwy
Lynwood, CA 90262
Phone (310) 605-4260

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A50125CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medardo Supnet M.D. Inc PastSince Nov 30, 2025 Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Medardo C. Supnet, M.D., Inc Specialist PastSince Nov 30, 2025 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1780796763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 E. IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 E. IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-605-4260",
            "fax_number": "310-605-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENTINO",
        "first_name": "ANDREW",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A50125",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A50125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.