Healthcare Provider Details

I. General information

NPI: 1568907640
Provider Name (Legal Business Name): LILIANI FLORES I NURSING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LILIANI FLORES NURSING

II. Dates (important events)

Enumeration Date: 12/28/2016
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 4108
COAMO PR
00769-9101
US

IV. Provider business mailing address

HC 01 BOX 4108
COAMO PUERTO RICO
00769
UM

V. Phone/Fax

Practice location:
  • Phone: 787-678-2932
  • Fax: 787-789-6712
Mailing address:
  • Phone: 787-678-2932
  • Fax: 787-789-6712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number26840A
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: