Provider Demographics
NPI:1578746269
Name:FLOROS, JESSICA LYNN
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:FLOROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14915 HAWICK MANOR LN
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-6406
Mailing Address - Country:US
Mailing Address - Phone:815-501-6750
Mailing Address - Fax:704-778-3544
Practice Address - Street 1:14915 HAWICK MANOR LN
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-6406
Practice Address - Country:US
Practice Address - Phone:815-501-6750
Practice Address - Fax:704-778-3544
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies