Provider Demographics
NPI:1619668613
Name:FLORES, SOFIA MARIE (MEDICAL STUDENT)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:MARIE
Last Name:FLORES
Suffix:
Gender:F
Credentials:MEDICAL STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2656 SW 25TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2221
Mailing Address - Country:US
Mailing Address - Phone:787-246-8731
Mailing Address - Fax:
Practice Address - Street 1:2656 SW 25TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2221
Practice Address - Country:US
Practice Address - Phone:787-246-8731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program