Healthcare Provider Details

I. General information

NPI: 1043847155
Provider Name (Legal Business Name): SERGIO EDUARDO FLORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 SUNRISE HWY
MERRICK NY
11566-3745
US

IV. Provider business mailing address

1728 SUNRISE HWY
MERRICK NY
11566-3745
US

V. Phone/Fax

Practice location:
  • Phone: 516-279-3352
  • Fax:
Mailing address:
  • Phone: 516-279-3352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number342384
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: