Healthcare Provider Details

I. General information

NPI: 1245963289
Provider Name (Legal Business Name): NAHIRA JARIS FLORES LRC, CRC, CVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 04/17/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JRG
SAN JUAN PR
00921
US

IV. Provider business mailing address

JRG
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 202-697-9213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number001519
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: