Healthcare Provider Details

I. General information

NPI: 1477403293
Provider Name (Legal Business Name): ANGELICA YVONNE FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2026
Last Update Date: 01/31/2026
Certification Date: 01/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N RENAISSANCE BLVD NE
ALBUQUERQUE NM
87107-7002
US

IV. Provider business mailing address

4125 W DE BACA ST
HOBBS NM
88242-9053
US

V. Phone/Fax

Practice location:
  • Phone: 505-356-7650
  • Fax:
Mailing address:
  • Phone: 575-266-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: