Healthcare Provider Details

I. General information

NPI: 1467816462
Provider Name (Legal Business Name): KYLE H FLORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 MENDENHALL OAKS PKWY
HIGH POINT NC
27265-8076
US

IV. Provider business mailing address

4010 MENDENHALL OAKS PKWY
HIGH POINT NC
27265-8076
US

V. Phone/Fax

Practice location:
  • Phone: 336-887-3195
  • Fax: 336-887-3194
Mailing address:
  • Phone: 336-887-3195
  • Fax: 336-887-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number217682
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number217682
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: