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General NPI Number Information
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NPI Number | 1700937505
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Entity Type | Individual
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Provider Name | ADDISON FLORES D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | EDIFICIO MICHAELANGELO CALLE ALELI #66 LOS LAURELES FULLANA
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City | CAYEY
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State | PR
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Zip | 00736-0000
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Country | US
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Telephone | 787-263-8940
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Fax | 787-263-7800
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Provider Business Mailing Address
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Address Line | CONDOMINIO ALTAMONTE # 100 CARR. 842 BOX 86
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City | SAN JUAN
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State | PR
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Zip | 00926-0000
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Country | US
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Telephone | 787-413-1719
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Fax | 787-263-7800
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2263
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License Number State | PR
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