Provider Demographics
NPI:1366542086
Name:FLORIANO, JON J (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:J
Last Name:FLORIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15561 W HIGH ST
Mailing Address - Street 2:HARRINGTON SQUARE SUITE 13
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9454
Mailing Address - Country:US
Mailing Address - Phone:440-632-1118
Mailing Address - Fax:440-632-1453
Practice Address - Street 1:15561 W HIGH ST
Practice Address - Street 2:HARRINGTON SQUARE SUITE 13
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9454
Practice Address - Country:US
Practice Address - Phone:440-632-1118
Practice Address - Fax:440-632-1453
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.073797208M00000X
OH35073797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2095058Medicaid
OH2095058Medicaid