Healthcare Provider Details

I. General information

NPI: 1578737300
Provider Name (Legal Business Name): ALEJANDRO ALBERTO FLORES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 MAIN ST
HACKENSACK NJ
07601-4812
US

IV. Provider business mailing address

385 SUMMIT AVE
HACKENSACK NJ
07601-1414
US

V. Phone/Fax

Practice location:
  • Phone: 201-489-3678
  • Fax: 201-489-7618
Mailing address:
  • Phone: 410-262-8208
  • Fax: 201-489-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09774300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: