Provider Demographics
NPI:1043545684
Name:FLORES DENTAL GROUP, PA
Entity Type:Organization
Organization Name:FLORES DENTAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZUZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-485-0072
Mailing Address - Street 1:11890 SW 8TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1743
Mailing Address - Country:US
Mailing Address - Phone:305-485-0072
Mailing Address - Fax:305-485-0080
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1743
Practice Address - Country:US
Practice Address - Phone:305-485-0072
Practice Address - Fax:305-485-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN186731223G0001X
FLDN176601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty