Healthcare Provider Details

I. General information

NPI: 1386981983
Provider Name (Legal Business Name): OMAR RENATO FLORES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5432 CARPINTERIA AVE
CARPINTERIA CA
93013-1423
US

IV. Provider business mailing address

701 W CENTER AVE
VISALIA CA
93291-6015
US

V. Phone/Fax

Practice location:
  • Phone: 805-566-0600
  • Fax: 805-566-0637
Mailing address:
  • Phone: 559-713-6806
  • Fax: 559-713-6809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number39684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: