Provider Demographics
NPI:1265401590
Name:FLORES CHEVEREZ, VICTOR LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LUIS
Last Name:FLORES CHEVEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9260
Mailing Address - Street 2:PLAZA CAROLINA STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-9260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ASHFORD MEDICAL CTR
Practice Address - Street 2:SUITE 502
Practice Address - City:CONDADO
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-721-7560
Practice Address - Fax:787-721-7560
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6967OtherSTATE LICENCE OF PR
PR9180154OtherHUMANA
PR601624OtherMMM
PR06871OtherLA CRUZ AZUL DE PR
PR9180154OtherHUMANA
PR0028832Medicare ID - Type UnspecifiedPROVEDER NUMBER