Healthcare Provider Details

I. General information

NPI: 1629969837
Provider Name (Legal Business Name): KARLA NICOLE FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR RM D1-40
GAINESVILLE FL
32610-3006
US

IV. Provider business mailing address

6401 S MITCHELL MANOR CIR
PINECREST FL
33156-4878
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7643
  • Fax:
Mailing address:
  • Phone: 305-904-1131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDN30679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: