Healthcare Provider Details

I. General information

NPI: 1215293345
Provider Name (Legal Business Name): AMI M FLORES RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 PEACH CT UNIT 3
CHULA VISTA CA
91913-8311
US

IV. Provider business mailing address

1823 PEACH CT UNIT 3
CHULA VISTA CA
91913-8311
US

V. Phone/Fax

Practice location:
  • Phone: 707-761-2376
  • Fax:
Mailing address:
  • Phone: 707-761-2376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number731358
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number731358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: