Provider Demographics
NPI:1225539745
Name:FLORES NEGRON, SARA IVELISSE
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:IVELISSE
Last Name:FLORES NEGRON
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:HC 1 BOX 3266
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9710
Mailing Address - Country:US
Mailing Address - Phone:787-477-9473
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA ALBA
Practice Address - Street 2:CALLE B 32
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-9701
Practice Address - Country:US
Practice Address - Phone:787-477-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19838208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice