Healthcare Provider Details

I. General information

NPI: 1063040129
Provider Name (Legal Business Name): ANDREA FLORES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA FLORES BURROUGHS MD

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 FAYETTEVILLE ST
DURHAM NC
27707-2325
US

IV. Provider business mailing address

2301 ERWIN RD
DURHAM NC
27705-4699
US

V. Phone/Fax

Practice location:
  • Phone: 919-956-4000
  • Fax:
Mailing address:
  • Phone: 919-684-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2023-02441
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: