Provider Demographics
NPI:1043273519
Name:JORGE FLORES, JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:JORGE FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580224
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-0003
Mailing Address - Country:US
Mailing Address - Phone:407-267-8823
Mailing Address - Fax:
Practice Address - Street 1:141 N 6TH ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4207
Practice Address - Country:US
Practice Address - Phone:407-201-7918
Practice Address - Fax:863-438-6624
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN292208D00000X, 261Q00000X
PR13735208D00000X
FLACN 292208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR201923OtherPREFERRED HEALTH
PR82213OtherTRIPLE S
PR061733OtherCRUZ AZUL
PR3281OtherAMERICAN HEALTH
PR7140009OtherHUMANA HEALTH PLANS
PR400291OtherMEDICARE Y MUCHO MAS
PRJJF210OtherMENONITA
PR0082213Medicare ID - Type UnspecifiedMEDICARE
PR400291OtherMEDICARE Y MUCHO MAS