Maricel Flores

Individual provider Active NPI Contractor · Indianapolis, IN

NPI 1992012546 · NPPES record last updated Sep 2, 2010

Key facts

NPI
1992012546
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
008407 (CT)
Practice address
5980 W 71St St Ste 102
Indianapolis, IN 46278-1785
Phone
(317) 388-0800
Fax
(317) 388-0805
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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)
No

State licenses

LicenseStateTypeSpecialty
008407CTMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Therapies,Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 008407 CT Yes

Addresses

Primary practice location

5980 W 71St St Ste 102
Indianapolis, IN 46278-1785

Mailing address

5980 W 71St St Ste 102
Indianapolis, IN 46278-1785
Phone (317) 388-0800

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Contractor in Indiana

Sources for this page

Verify at the official NPI Registry.