Provider Demographics
NPI:1073657243
Name:FLORES, OSCAR MANUEL
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:MANUEL
Last Name:FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17681 CINQUEZ PARK RD W
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3998
Mailing Address - Country:US
Mailing Address - Phone:561-427-7200
Mailing Address - Fax:561-427-7203
Practice Address - Street 1:17681 CINQUEZ PARK RD W
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3998
Practice Address - Country:US
Practice Address - Phone:561-427-7200
Practice Address - Fax:561-427-7203
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9599174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist