Provider Demographics
NPI:1811947765
Name:GERARD Q FLORES MD PLLC
Entity type:Organization
Organization Name:GERARD Q FLORES MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:Q
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-465-1170
Mailing Address - Street 1:2000 HARTMAN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-4412
Mailing Address - Country:US
Mailing Address - Phone:772-465-1170
Mailing Address - Fax:772-465-1171
Practice Address - Street 1:2000 HARTMAN RD STE 2
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4412
Practice Address - Country:US
Practice Address - Phone:772-465-1170
Practice Address - Fax:772-465-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF1972086OtherDEA