Provider Demographics
NPI:1205898939
Name:RODRIGUEZ-FLORES, REGINO (MD)
Entity type:Individual
Prefix:
First Name:REGINO
Middle Name:
Last Name:RODRIGUEZ-FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 SUN N LAKE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2171
Mailing Address - Country:US
Mailing Address - Phone:863-382-8880
Mailing Address - Fax:863-382-9582
Practice Address - Street 1:4325 SUN N LAKE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2171
Practice Address - Country:US
Practice Address - Phone:863-382-8880
Practice Address - Fax:863-382-9582
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036843207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000663723Medicaid
FL370832200Medicaid
FLC84098Medicare UPIN
FL18500Medicare ID - Type Unspecified
FL370832200Medicaid