MEDICARE: JOSE FLORES PA

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	363A00000X	Physician Assistant	PA9100145	FL

General Provider Information

NPI Number	:	1558339549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE FLORES PA

Provider Business Mailing Address
First Line	:	3000 MEDICAL PARK DR STE 450
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-972-5420
Fax Number	:	813-977-2021

Provider Business Practice Location Address
First Line	:	3000 MEDICAL PARK DR STE 450
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-972-5420
Fax Number	:	813-977-2021

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	03/30/2022

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Directions to “ JOSE FLORES PA” Practice Location

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