Provider Demographics
NPI:1982990545
Name:FLORES MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:FLORES MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAMISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-249-7374
Mailing Address - Street 1:5011 W HILLSBOROUGH AVE STE M
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5309
Mailing Address - Country:US
Mailing Address - Phone:813-249-7374
Mailing Address - Fax:813-249-6969
Practice Address - Street 1:5011 W HILLSBOROUGH AVE STE M
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5309
Practice Address - Country:US
Practice Address - Phone:813-249-7374
Practice Address - Fax:813-249-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8923261Q00000X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center