Healthcare Provider Details

I. General information

NPI: 1801762513
Provider Name (Legal Business Name): LIZ CASIS-FLORES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 N 2ND ST STE 500
PHOENIX AZ
85012-2367
US

IV. Provider business mailing address

799 CAMINO LA PAZ
HENDERSON NV
89012-5687
US

V. Phone/Fax

Practice location:
  • Phone: 623-306-7250
  • Fax: 623-306-7251
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11494
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: