Provider Demographics
NPI:1801015060
Name:FLORES, NESTOR J (MD)
Entity Type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:J
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 1:71 PARQ INTERAMERICANA
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-7337
Mailing Address - Country:US
Mailing Address - Phone:787-866-6682
Mailing Address - Fax:787-866-3399
Practice Address - Street 1:LA FUENTE TOWN CENTER SUITE 211
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-6682
Practice Address - Fax:787-866-3399
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12942207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH82101Medicare UPIN
PR89786Medicare ID - Type UnspecifiedPROVIDER NUMBER