Healthcare Provider Details

I. General information

NPI: 1700449691
Provider Name (Legal Business Name): ALEXIS MARLENE FLOREA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS MARLENE BARAJAS TERRONES MD

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9961 SIERRA AVE
FONTANA CA
92335-6720
US

IV. Provider business mailing address

9961 SIERRA AVE
FONTANA CA
92335-6720
US

V. Phone/Fax

Practice location:
  • Phone: 909-302-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA176537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: