Provider Demographics
NPI:1093116568
Name:FLORES, MELISSA R (DO)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:R
Last Name:FLORES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 RIVERBANK ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-4211
Mailing Address - Country:US
Mailing Address - Phone:734-444-5719
Mailing Address - Fax:
Practice Address - Street 1:1011 RIVERBANK ST
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-4211
Practice Address - Country:US
Practice Address - Phone:734-444-5719
Practice Address - Fax:888-366-7450
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager