Provider Demographics
NPI:1912124272
Name:FLORES, MICHAEL ANGELO (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:736 IRVING AVE STE 9100
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1687
Mailing Address - Country:US
Mailing Address - Phone:315-470-7379
Mailing Address - Fax:315-470-2923
Practice Address - Street 1:33-57 HARRISON ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2107
Practice Address - Country:US
Practice Address - Phone:315-470-7379
Practice Address - Fax:315-470-2923
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2016-12-22
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Provider Licenses
StateLicense IDTaxonomies
NY2263352080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02387997Medicaid