MEDICARE: SAMANTHA G FLORES FNP-C

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	363LF0000X	Family Nurse Practitioner	R219547	MD
2	363LF0000X	Family Nurse Practitioner	APRN11014856	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750992293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA G FLORES FNP-C

Provider Business Mailing Address
First Line	:	3989 BOSTON ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-5759
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41214 FISHER ISLAND DR
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33109-1255
Country	:	US
Telephone Number	:	305-503-8634
Fax Number	:

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

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	06/17/2022

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