Provider Demographics
NPI:1215663190
Name:FLORES GUEVARA, AMED EDUARDO
Entity type:Individual
Prefix:
First Name:AMED
Middle Name:EDUARDO
Last Name:FLORES GUEVARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7762 PANAMA ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3564
Mailing Address - Country:US
Mailing Address - Phone:786-656-2440
Mailing Address - Fax:
Practice Address - Street 1:7762 PANAMA ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3564
Practice Address - Country:US
Practice Address - Phone:786-656-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician