Provider Demographics
NPI:1932317310
Name:FLORES, DOLORES AIDA (MS,LMHC)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:AIDA
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9737 NW 41ST ST # 259
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2924
Mailing Address - Country:US
Mailing Address - Phone:305-494-9791
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY STE 130S
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2071
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health