Provider Demographics
NPI:1649253733
Name:FLORES, ADELINA CORTES (MD)
Entity type:Individual
Prefix:DR
First Name:ADELINA
Middle Name:CORTES
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 HARBOR BLVD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5052
Mailing Address - Country:US
Mailing Address - Phone:941-629-4422
Mailing Address - Fax:941-627-3084
Practice Address - Street 1:2400 HARBOR BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5052
Practice Address - Country:US
Practice Address - Phone:941-629-4422
Practice Address - Fax:941-627-3084
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33549207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08083OtherBLUE SHIELD
FL08083OtherBLUE SHIELD
FL08083Medicare ID - Type UnspecifiedMEDICARE