Healthcare Provider Details

I. General information

NPI: 1932414059
Provider Name (Legal Business Name): ELMER FLORES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 NW 99TH AVE FL 2
CORAL SPRINGS FL
33065-4038
US

IV. Provider business mailing address

601 N FLAMINGO RD STE 403B
PEMBROKE PINES FL
33028-1011
US

V. Phone/Fax

Practice location:
  • Phone: 954-432-6595
  • Fax: 954-432-6266
Mailing address:
  • Phone: 954-432-6595
  • Fax: 954-432-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9103423
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: