Healthcare Provider Details

I. General information

NPI: 1508948860
Provider Name (Legal Business Name): ARTURO R FLORES JR. ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MERCER ST
NEW YORK NY
10012-1501
US

IV. Provider business mailing address

2 INVERNESS RD
NEW ROCHELLE NY
10804-3515
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-2083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00123000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number001192
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: