Provider Demographics
NPI:1043279227
Name:FLORES, RAMON LEONIDAS (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LEONIDAS
Last Name:FLORES
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 1:819 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4812
Mailing Address - Country:US
Mailing Address - Phone:201-489-3678
Mailing Address - Fax:201-489-7618
Practice Address - Street 1:819 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4812
Practice Address - Country:US
Practice Address - Phone:201-489-3678
Practice Address - Fax:201-489-7618
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA048688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist