Provider Demographics
NPI:1568431922
Name:FLORES, JAIME IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:IVAN
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 SW 38TH AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1530
Mailing Address - Country:US
Mailing Address - Phone:786-409-4135
Mailing Address - Fax:786-703-6196
Practice Address - Street 1:3150 SW 38TH AVE STE 800
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1530
Practice Address - Country:US
Practice Address - Phone:786-409-4135
Practice Address - Fax:786-703-6196
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106104208200000X
MDD0059471208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI43012Medicare UPIN