Healthcare Provider Details

I. General information

NPI: 1497672620
Provider Name (Legal Business Name): GENESIS GISSELLE FLORES GARCIA PARAMEDIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 LEWISVILLE CLEMMONS RD STE C
CLEMMONS NC
27012-7459
US

IV. Provider business mailing address

511 N CHERRY ST APT 211
WINSTON SALEM NC
27101-3085
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-8575
  • Fax:
Mailing address:
  • Phone: 336-934-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP542947
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: