Healthcare Provider Details

I. General information

NPI: 1972428621
Provider Name (Legal Business Name): ALEXANDRA RENEE FLORES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 S LEWIS AVE
TULSA OK
74105-7104
US

IV. Provider business mailing address

2532 N MARTIN LUTHER KING JR BLVD
TULSA OK
74106-6426
US

V. Phone/Fax

Practice location:
  • Phone: 918-401-0064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7159
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: