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General NPI Number Information
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NPI Number | 1154955086
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Entity Type | Individual
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Provider Name | THOMAS F FLOREZ AGNP
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Gender | Male
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Dates
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Enumeration Date | 02/29/2020
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Last Update Date | 02/29/2020
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Provider Practice Location Address
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Address Line | 1000 MONTAUK HWY
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City | WEST ISLIP
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State | NY
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Zip | 11795-4927
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Country | US
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Telephone | 631-376-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WATERMAN ST
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City | BABYLON
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State | NY
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Zip | 11702-2018
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Country | US
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Telephone | 631-707-0743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 309579
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License Number State | NY
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