Healthcare Provider Details

I. General information

NPI: 1922920156
Provider Name (Legal Business Name): PASCUAL FLORES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 WOODWAY OAK CIR APT 1328
MATTHEWS NC
28105-8384
US

IV. Provider business mailing address

8114 WOODWAY OAK CIR APT 1328
MATTHEWS NC
28105-8384
US

V. Phone/Fax

Practice location:
  • Phone: 980-282-8140
  • Fax: 980-282-8140
Mailing address:
  • Phone: 980-282-8140
  • Fax: 980-282-8140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number00043245898
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: