Provider Demographics
NPI:1588009559
Name:FLORES, MARIA LOURDES R (MD)
Entity Type:Individual
Prefix:
First Name:MARIA LOURDES
Middle Name:R
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 CORLEAR AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5180
Mailing Address - Country:US
Mailing Address - Phone:718-543-2700
Mailing Address - Fax:718-601-0965
Practice Address - Street 1:3050 CORLEAR AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5180
Practice Address - Country:US
Practice Address - Phone:718-543-2700
Practice Address - Fax:718-601-0965
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine