Provider Demographics
NPI:1316950074
Name:FLORES SANDOVAL, ALEJANDRO F (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:F
Last Name:FLORES SANDOVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:116 FULLER ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2803
Mailing Address - Country:US
Mailing Address - Phone:617-956-0516
Mailing Address - Fax:
Practice Address - Street 1:750 WASHINGTON ST
Practice Address - Street 2:NEW ENGLAND MEDICAL CENTER (TUFTS)
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-0136
Practice Address - Fax:617-636-8718
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2014-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA593162080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B73836Medicare UPIN