Provider Demographics
NPI:1568422384
Name:FLORES, HEATHER (MS, MTC, DPT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS, MTC, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1296 NW 170TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1921
Mailing Address - Country:US
Mailing Address - Phone:954-252-6014
Mailing Address - Fax:954-252-6015
Practice Address - Street 1:5856 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-3238
Practice Address - Country:US
Practice Address - Phone:954-252-6014
Practice Address - Fax:954-252-6015
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDPT152762251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic