Healthcare Provider Details

I. General information

NPI: 1811329030
Provider Name (Legal Business Name): JOSE RAMON FLORES JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 JORALEMON ST APT. 6F
BROOKLYN NY
11201-4357
US

IV. Provider business mailing address

150 JORALEMON ST APT. 6F
BROOKLYN NY
11201-4357
US

V. Phone/Fax

Practice location:
  • Phone: 718-852-4709
  • Fax:
Mailing address:
  • Phone: 718-852-4709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number238080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: