Provider Demographics
NPI:1104122712
Name:FLORES MARTIN, DUNIA (MA)
Entity type:Individual
Prefix:
First Name:DUNIA
Middle Name:
Last Name:FLORES MARTIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 NW 79TH AVE STE 704
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6561
Mailing Address - Country:US
Mailing Address - Phone:786-312-9426
Mailing Address - Fax:
Practice Address - Street 1:3900 NW 79TH AVE STE 704
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6561
Practice Address - Country:US
Practice Address - Phone:786-312-9426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA45352225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist