Provider Demographics
NPI:1841616042
Name:FLORES, ROSA IRMA (MS)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:IRMA
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:ROSA
Other - Middle Name:IRMA
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:N2 CALLE PEDRO FLORES
Mailing Address - Street 2:URB. BORINQUEN
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3376
Mailing Address - Country:US
Mailing Address - Phone:787-851-9682
Mailing Address - Fax:
Practice Address - Street 1:N2 CALLE PEDRO FLORES
Practice Address - Street 2:URB. BORINQUEN
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3376
Practice Address - Country:US
Practice Address - Phone:787-851-9682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist