Provider Demographics
NPI:1639167513
Name:FLORES, MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
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 1:8200 SW 117TH AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3856
Mailing Address - Country:US
Mailing Address - Phone:305-279-1501
Mailing Address - Fax:305-279-1593
Practice Address - Street 1:8200 SW 117TH AVE
Practice Address - Street 2:STE 301
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4826
Practice Address - Country:US
Practice Address - Phone:305-279-1501
Practice Address - Fax:305-279-1593
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87988174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269782300Medicaid
FLH64995Medicare UPIN
FL269782300Medicaid