Healthcare Provider Details

I. General information

NPI: 1649702416
Provider Name (Legal Business Name): JONATHAN FLOREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W 3RD ST
SILER CITY NC
27344-3037
US

IV. Provider business mailing address

801 W 3RD ST
SILER CITY NC
27344-3037
US

V. Phone/Fax

Practice location:
  • Phone: 919-742-2209
  • Fax:
Mailing address:
  • Phone: 401-999-3189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024-00450
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: