Provider Demographics
NPI:1861576605
Name:FLORES, OFELIA R (MD)
Entity type:Individual
Prefix:DR
First Name:OFELIA
Middle Name:R
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:88 OLD COLONY RD
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3618
Mailing Address - Country:US
Mailing Address - Phone:718-681-6073
Mailing Address - Fax:718-681-0347
Practice Address - Street 1:1015 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5104
Practice Address - Country:US
Practice Address - Phone:718-681-6073
Practice Address - Fax:718-681-0347
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY107550207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00189533Medicaid
NYB17380Medicare UPIN