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NPI Code Detail

MEDICARE: JONATHAN IVAN FLORES

MEDICARE:   JONATHAN IVAN 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
1225200000XPhysical Therapy Assistant2112335TX

General Provider Information

NPI Number : 1811476088
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN IVAN FLORES
Provider Business Mailing Address
First Line : 801 N GARZA ST
Second Line :
City : RIO GRANDE CITY
State : TX
Zip : 78582-3326
Country : US
Telephone Number : 956-263-9761
Fax Number :
Provider Business Practice Location Address
First Line : 5346 E US HIGHWAY 83 STE 2
Second Line :
City : RIO GRANDE CITY
State : TX
Zip : 78582-9418
Country : US
Telephone Number : 956-317-1285
Fax Number : 956-317-1291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 08/08/2018

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Directions to “ JONATHAN IVAN FLORES ” Practice Location

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