Provider Demographics
NPI:1730691452
Name:FLORES, KIMBERLY MELISSA
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MELISSA
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3007
Mailing Address - Country:US
Mailing Address - Phone:718-374-2618
Mailing Address - Fax:646-371-3955
Practice Address - Street 1:147 PRINCE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3007
Practice Address - Country:US
Practice Address - Phone:718-374-5949
Practice Address - Fax:646-374-3955
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)