Healthcare Provider Details

I. General information

NPI: 1578411849
Provider Name (Legal Business Name): MS. MAYRA FLORES CONTRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S CENTER ST
THURMONT MD
21788-1945
US

IV. Provider business mailing address

180 THOMAS JOHNSON DR 101
FREDERICK MD
21702
US

V. Phone/Fax

Practice location:
  • Phone: 301-696-8802
  • Fax:
Mailing address:
  • Phone: 301-696-8802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR277455
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: