Provider Demographics
NPI:1477996247
Name:FLORES, MYLA C (CD(DONA), CLC, LCCE)
Entity Type:Individual
Prefix:MS
First Name:MYLA
Middle Name:C
Last Name:FLORES
Suffix:
Gender:F
Credentials:CD(DONA), CLC, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 W 158TH ST APT 27
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7255
Mailing Address - Country:US
Mailing Address - Phone:917-795-1186
Mailing Address - Fax:
Practice Address - Street 1:559 W 158TH ST APT 27
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7255
Practice Address - Country:US
Practice Address - Phone:917-795-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN