Healthcare Provider Details

I. General information

NPI: 1033188404
Provider Name (Legal Business Name): MARIBETT FLORES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 LINCOLN DR E
MARLTON NJ
08053-1500
US

IV. Provider business mailing address

5 BERGAN CT
MARLTON NJ
08053-5378
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-4487
  • Fax: 267-292-9411
Mailing address:
  • Phone: 732-552-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00025900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ00025900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: