Provider Demographics
NPI:1376292037
Name:FLORES, FELIPE DE JESUS (MD)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:DE JESUS
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FELIPE
Other - Middle Name:DE JESUS
Other - Last Name:FLORES AGUILAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:720 W OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4998
Mailing Address - Country:US
Mailing Address - Phone:407-518-2772
Mailing Address - Fax:
Practice Address - Street 1:720 W OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4998
Practice Address - Country:US
Practice Address - Phone:407-518-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program