Provider Demographics
NPI:1568796365
Name:FLORES, ALEXIS H (MOT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:H
Last Name:FLORES
Suffix:
Gender:M
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 OFFICE PARK DRIVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3830
Mailing Address - Country:US
Mailing Address - Phone:386-447-0011
Mailing Address - Fax:386-447-0161
Practice Address - Street 1:14 OFFICE PARK DRIVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3830
Practice Address - Country:US
Practice Address - Phone:386-447-0011
Practice Address - Fax:386-447-0161
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist