Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 13735 | PR |
Y | 208D00000X | General Practice Physician | ACN 292 | FL |
N | 208D00000X | General Practice Physician | ACN292 | FL |
NPI | 1043273519 |
---|---|
Provider Name | Dr. Jaime Jorge Flores |
First Address | Kissimmee, FL 34758-0003 |
Second Address | Kissimmee, FL 34746-2706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 13/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061733 | CRUZ AZUL (01) | PR |
201923 | PREFERRED HEALTH (01) | PR |
3281 | AMERICAN HEALTH (01) | PR |
400291 | MEDICARE Y MUCHO MAS (01) | PR |
7140009 | HUMANA HEALTH PLANS (01) | PR |
82213 | TRIPLE S (01) | PR |
H79324 | (02) | PR |
JJF210 | MENONITA (01) | PR |