Provider Demographics
NPI:1841726262
Name:FLORES ROSA, JOSE RAMON
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAMON
Last Name:FLORES ROSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 683 KM 0 HM 8
Mailing Address - Street 2:HC 52 BOX 2343
Mailing Address - City:ARECIBO
Mailing Address - State:PR - PUERTO RICO
Mailing Address - Zip Code:00652
Mailing Address - Country:UM
Mailing Address - Phone:787-201-2981
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE
Practice Address - Street 2:OLD COMMUNITY HEALTH CENTER
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-641-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR132231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4396OtherPREVENTIVE COUNSELING FOR VIH
PR356OtherAUXILIARY COUNSELING IN PSYCHOACTIVE SUBSTANCES