MEDICARE: GWYNNEL FLORES LCSW

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	1041C0700X	Clinical Social Worker	SW19228	FL

General Provider Information

NPI Number	:	1477413169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWYNNEL FLORES LCSW

Provider Business Mailing Address
First Line	:	8801 NW 14TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-4722
Country	:	US
Telephone Number	:	516-303-6509
Fax Number	:

Provider Business Practice Location Address
First Line	:	8801 NW 14TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-4722
Country	:	US
Telephone Number	:	516-303-6509
Fax Number	:

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

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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