Provider Demographics
NPI:1083157846
Name:FLORES, AMELIA S
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:S
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WOODBINE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-4945
Mailing Address - Country:US
Mailing Address - Phone:718-473-8230
Mailing Address - Fax:718-574-1080
Practice Address - Street 1:88 WOODBINE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-4945
Practice Address - Country:US
Practice Address - Phone:718-473-8230
Practice Address - Fax:718-574-1080
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist