Provider Demographics
NPI:1396945051
Name:BRAULIO FLORES, MD, PLLC
Entity type:Organization
Organization Name:BRAULIO FLORES, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-202-7740
Mailing Address - Street 1:1 STONE PL
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3426
Mailing Address - Country:US
Mailing Address - Phone:914-202-7740
Mailing Address - Fax:914-346-8266
Practice Address - Street 1:1 STONE PL
Practice Address - Street 2:SUITE 302
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3426
Practice Address - Country:US
Practice Address - Phone:914-202-7740
Practice Address - Fax:914-346-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223994207RA0000X, 207RS0010X, 208000000X, 2080A0000X, 2080S0010X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3705930OtherAETNA HMO
NY683AC1OtherEMPIRE BLUE CROSS/SHEILD
NY6C5961OtherHEALTH NET
NY0174622OtherGHI
NY02769449OtherMAGNACARE
NY5333768OtherAETNA PPO
NY2239941OtherHIP
NYP340056OtherOXFORD
NY0739492OtherCIGNA
NY219924601OtherUNITED HEALTHCARE
NY000000119735OtherGHI HMO
NY219924601OtherUNITED HEALTHCARE
NY6C5961OtherHEALTH NET