Healthcare Provider Details

I. General information

NPI: 1568431922
Provider Name (Legal Business Name): JAIME IVAN FLORES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 SW 38TH AVE STE 800
MIAMI FL
33146-1530
US

IV. Provider business mailing address

3150 SW 38TH AVE STE 800
MIAMI FL
33146-1530
US

V. Phone/Fax

Practice location:
  • Phone: 786-409-4135
  • Fax: 786-703-6196
Mailing address:
  • Phone: 786-409-4135
  • Fax: 786-703-6196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME106104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: