Healthcare Provider Details

I. General information

NPI: 1649025180
Provider Name (Legal Business Name): ADELAIDE FLOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

1758 SCHLEGEL RD
WEBSTER NY
14580-9608
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2100
  • Fax:
Mailing address:
  • Phone: 585-236-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3494
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: