Healthcare Provider Details
I. General information
NPI: 1003809435
Provider Name (Legal Business Name): MARIA R FLORES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2005
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 W GORE ST SUITE 100
ORLANDO FL
32806-1124
US
IV. Provider business mailing address
PO BOX 102222 ATTN: CREDENTIALING
ATLANTA GA
30368-2222
US
V. Phone/Fax
- Phone: 407-426-8484
- Fax: 404-426-8575
- Phone: 239-274-8200
- Fax: 239-278-3350
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME60281 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | ME60281 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | ME60281 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: