Individual provider Active NPI

Michael Flores, PA-C

  • Medical Physician Assistant
  • Cape Coral, FL
National Provider Identifier
1689706152
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101210 Issued in FL
Practice address
1528 Del Prado Blvd S
Cape Coral, FL 33990-3798
Phone
(239) 458-3338
Fax
(239) 458-0666
NPI assigned
Mar 11, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000020CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Current
since Jul 1, 2018
Accepting new patients
Millennium Physician Group LLC Current
since Jul 1, 2018
Accepting new patients
Internal Medicine Associates of Lee County Hospitalist Group, LLC Past Accepting new patients
Emergency Physicians of Naples PLLC Past Accepting new patients
Gulf Coast Hma Physician Management LLC Past Accepting new patients

Locations

24600 S Tamiami Trl
Ste 400
Bonita Springs, FL 34134
Phone (239) 948-3761

1528 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 458-3338

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101210 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

1528 Del Prado Blvd S
Cape Coral, FL 33990-3798

Mailing address

PO Box 62707
Fort Myers, FL 33906-2707
Phone (239) 931-3440

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
291844700MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 5, 2016.

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1689706152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62707",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339062707",
            "telephone_number": "239-931-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903798",
            "telephone_number": "239-458-3338",
            "fax_number": "239-458-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291844700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.