Healthcare Provider Details

I. General information

NPI: 1700091584
Provider Name (Legal Business Name): JENNIFER LYNN FLORES PA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5996 E 64TH AVE
COMMERCE CITY CO
80022-3317
US

IV. Provider business mailing address

2200 E 104TH AVE STE 115
THORNTON CO
80233-4402
US

V. Phone/Fax

Practice location:
  • Phone: 720-463-6758
  • Fax: 720-640-3314
Mailing address:
  • Phone: 303-452-2766
  • Fax: 303-252-8694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0002291
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: