MEDICARE: EDDY FLORES DE HOSTOS SR. MD

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	207RC0000X	Cardiovascular Disease Physician	5679	PR

General Provider Information

NPI Number	:	1326107012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDY FLORES DE HOSTOS SR. MD

Provider Business Mailing Address
First Line	:	MIRADOR #80 PASEO ALTO
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-748-7332
Fax Number	:

Provider Business Practice Location Address
First Line	:	DE DIEGO 405
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00923-3012
Country	:	US
Telephone Number	:	787-764-1580
Fax Number	:	787-766-1858

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

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	04/08/2008

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