Individual
LICETTE MARIE FLORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
UPR , RCM, CARDIOVASCULAR CENTER, 8TH FLOOR ROOM 815, SAN JUAN, PR 00936-5067
(787) 759-9595
Mailing address
428 VIA ESCORIAL, VILLA REALES, GUAYNABO, PR 00969-5349
(787) 789-1143
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9587
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9587
STATE LICENSE NUMBER
PR
Enumeration date
06/27/2006
Last updated
07/08/2007
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