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NPI Code Detail

MEDICARE: MR. RICARDO ISIDORO FLORES

MEDICARE: MR. RICARDO ISIDORO FLORES
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1538703533
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICARDO ISIDORO FLORES
Provider Business Mailing Address
First Line : 3005 NE KINGSBRIAR DR
Second Line :
City : LAWTON
State : OK
Zip : 73507-1918
Country : US
Telephone Number : 806-930-0776
Fax Number :
Provider Business Practice Location Address
First Line : 8501 NW MADISCHE RD
Second Line :
City : LAWTON
State : OK
Zip : 73507-1221
Country : US
Telephone Number : 580-492-3614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2019
Last Update Date : 11/01/2019

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