Healthcare Provider Details

I. General information

NPI: 1225007669
Provider Name (Legal Business Name): LUCKY FLORES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 NW 155TH ST
MIAMI LAKES FL
33016-5880
US

IV. Provider business mailing address

8040 NW 155TH ST
MIAMI LAKES FL
33016-5880
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-0208
  • Fax: 305-827-0280
Mailing address:
  • Phone: 305-827-0208
  • Fax: 305-827-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME75421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: