MEDICARE: BRANDON M FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT012063	OH

General Provider Information

NPI Number	:	1093559692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON M FLORES

Provider Business Mailing Address
First Line	:	7969 LAVELLE RD
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-8744
Country	:	US
Telephone Number	:	330-696-2742
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 COLUMBUS CIR
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-1370
Country	:	US
Telephone Number	:	740-592-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	06/19/2024

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Directions to “ BRANDON M FLORES ” Practice Location

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