MEDICARE: IBIS FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227800000X	Certified Respiratory Therapist	TT15624	FL

General Provider Information

NPI Number	:	1013593441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IBIS FLORES

Provider Business Mailing Address
First Line	:	4736 LAGO VISTA DR
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-4930
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4574 SAN FRATELLO CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-5074
Country	:	US
Telephone Number	:	954-901-0616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	03/24/2021

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