Provider Demographics
NPI:1700173770
Name:FLORES, CARMEN D (MHSA)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:D
Last Name:FLORES
Suffix:
Gender:F
Credentials:MHSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7891
Mailing Address - Street 2:PMB 441
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-354-4705
Mailing Address - Fax:787-998-3398
Practice Address - Street 1:CALLE 6 S6-1
Practice Address - Street 2:EL ESCORIAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-354-4705
Practice Address - Fax:787-998-3398
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332900000XSuppliersNon-Pharmacy Dispensing Site