Provider Demographics
NPI:1740307354
Name:SANTOS-FLORES, BYRON A (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:A
Last Name:SANTOS-FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BYRON
Other - Middle Name:A
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12990 MANCHESTER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1860
Mailing Address - Country:US
Mailing Address - Phone:314-909-0633
Mailing Address - Fax:314-909-0391
Practice Address - Street 1:12990 MANCHESTER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-1860
Practice Address - Country:US
Practice Address - Phone:314-909-0633
Practice Address - Fax:314-909-0391
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9F62207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180013399OtherMEDICARE RAILROAD
MO202336707Medicaid
4400520OtherAETNA
12458OtherOPTICARE
0800111OtherUNITED HEALTHCARE
MO24308OtherANTHEM BCBS
MO008248OtherEXCLUSIVE CHOICE
105378OtherHEALTHLINK
MO48680OtherCMR INSURANCE PLAN
A10321Medicare UPIN