Provider Demographics
NPI:1851692230
Name:FLORES, GLORIMAR (MS-SLP, RD, LND)
Entity type:Individual
Prefix:MRS
First Name:GLORIMAR
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS-SLP, RD, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10309 CALLE REY DAVID
Mailing Address - Street 2:RIO GRANDE ESTATES
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-550-5013
Mailing Address - Fax:
Practice Address - Street 1:10309 CALLE REY DAVID
Practice Address - Street 2:RIO GRANDE ESTATES
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-550-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1513133V00000X
PR4481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1513OtherDIETITIAN'S LICENCE
PR4481OtherSPEECH LANGUAGE PATHOLOGIST LICENCE