Provider Demographics
NPI:1780600205
Name:FLORES, DIONISIO C (MD)
Entity type:Individual
Prefix:DR
First Name:DIONISIO
Middle Name:C
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 420910
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34742-0910
Mailing Address - Country:US
Mailing Address - Phone:407-944-9888
Mailing Address - Fax:407-944-9931
Practice Address - Street 1:2400 N ORANGE BLOSSOM TRL STE 202
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-2307
Practice Address - Country:US
Practice Address - Phone:407-944-9888
Practice Address - Fax:407-944-9931
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063879208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD02366Medicare UPIN