Healthcare Provider Details

I. General information

NPI: 1346728763
Provider Name (Legal Business Name): EDUARDO ENRIQUE FLOREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 NW FEDERAL HWY STE 215
STUART FL
34994-1019
US

IV. Provider business mailing address

850 NW FEDERAL HWY STE 215
STUART FL
34994-1019
US

V. Phone/Fax

Practice location:
  • Phone: 772-529-8139
  • Fax:
Mailing address:
  • Phone: 772-529-8139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: