MEDICARE: MR. JOSHUA 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	163W00000X	Registered Nurse	544976	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	403680	NY

General Provider Information

NPI Number	:	1508278656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA FLORES

Provider Business Mailing Address
First Line	:	700 E 134TH ST APT 1B
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-3414
Country	:	US
Telephone Number	:	646-236-4393
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 E 134TH ST APT 1B
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-3414
Country	:	US
Telephone Number	:	646-236-4393
Fax Number	:

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

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	08/26/2021

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Directions to “ MR. JOSHUA FLORES ” Practice Location

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