Healthcare Provider Details

I. General information

NPI: 1770400103
Provider Name (Legal Business Name): JOSHUA FLORES PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 E UNIVERSITY DR
TEMPE AZ
85281
US

IV. Provider business mailing address

3031 S RURAL RD APT 41
TEMPE AZ
85282-3891
US

V. Phone/Fax

Practice location:
  • Phone: 480-527-0727
  • Fax: 480-247-8584
Mailing address:
  • Phone: 928-201-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA-015158
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: