Provider Demographics
NPI:1730338120
Name:DE LA FLOR, RICHARD R (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:DE LA FLOR
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 1:4859 W SYLVANIA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3371
Mailing Address - Country:US
Mailing Address - Phone:419-843-2776
Mailing Address - Fax:419-841-2698
Practice Address - Street 1:4859 W SYLVANIA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3371
Practice Address - Country:US
Practice Address - Phone:419-843-2776
Practice Address - Fax:419-841-2698
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine