Provider Demographics
NPI:1730175597
Name:FLOYD, KATRENA QUESENBERRY (MD)
Entity type:Individual
Prefix:
First Name:KATRENA
Middle Name:QUESENBERRY
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 407
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5752
Mailing Address - Country:US
Mailing Address - Phone:850-479-7636
Mailing Address - Fax:850-479-9935
Practice Address - Street 1:9400 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 407
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5752
Practice Address - Country:US
Practice Address - Phone:850-479-7636
Practice Address - Fax:850-479-9935
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 89863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59175167OtherBLUE CROSS BLUE SHIELD
FL7077618OtherAETNA
FL50285OtherBLUE CROSS BLUE SHIELD
FL50285OtherHEALTH OPTIONS
FL245577OtherWELLCARE
I13584Medicare UPIN
FL7077618OtherAETNA