MEDICARE: DR. NICOLE R. FLORA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	12743	NV
2	207Q00000X	Family Medicine Physician	35077148	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275538126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE R. FLORA MD

Provider Business Mailing Address
First Line	:	PO BOX 98978
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-8978
Country	:	US
Telephone Number	:	702-507-2430
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	3201 S MARYLAND PKWY
Second Line	:	SUITE 400
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2441
Country	:	US
Telephone Number	:	702-262-1130
Fax Number	:	702-262-1161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	01/26/2012

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Directions to “ DR. NICOLE R. FLORA MD” Practice Location

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