Healthcare Provider Details

I. General information

NPI: 1033430632
Provider Name (Legal Business Name): CYNTHIA A FLORES RT(R)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CHIEF EDDIE HOFFMAN HWY
BETHEL AK
99559
US

IV. Provider business mailing address

PO BOX 287
BETHEL AK
99559-0287
US

V. Phone/Fax

Practice location:
  • Phone: 907-543-6238
  • Fax: 907-543-6314
Mailing address:
  • Phone: 907-543-6238
  • Fax: 907-543-6314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: