Provider Demographics
NPI:1821460346
Name:FLORESCA, MARIA (PHD, NP)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:FLORESCA
Suffix:
Gender:F
Credentials:PHD, NP
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:ISABEL
Other - Last Name:SALOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9820 N KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4013
Mailing Address - Country:US
Mailing Address - Phone:843-497-2273
Mailing Address - Fax:843-497-2502
Practice Address - Street 1:9820 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4013
Practice Address - Country:US
Practice Address - Phone:843-497-2273
Practice Address - Fax:843-497-2502
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19806363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology