Provider Demographics
NPI:1174714554
Name:FLORIAN, STANISLAV
Entity type:Individual
Prefix:
First Name:STANISLAV
Middle Name:
Last Name:FLORIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 S 400 E STE 404
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-7065
Mailing Address - Country:US
Mailing Address - Phone:354-656-8918
Mailing Address - Fax:435-656-8917
Practice Address - Street 1:474 W 200 N
Practice Address - Street 2:SUTIE 100
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4505
Practice Address - Country:US
Practice Address - Phone:435-634-5600
Practice Address - Fax:435-986-8700
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTFLORISOtherSWCBH STAFF CODE