Provider Demographics
NPI:1235899899
Name:FLORES, SEBASTIAN LOUIS SR (MS)
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:LOUIS
Last Name:FLORES
Suffix:SR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:M7 CALLE 17
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3129
Mailing Address - Country:US
Mailing Address - Phone:787-308-1549
Mailing Address - Fax:
Practice Address - Street 1:M7 CALLE 17
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3129
Practice Address - Country:US
Practice Address - Phone:787-308-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty