Healthcare Provider Details

I. General information

NPI: 1326953266
Provider Name (Legal Business Name): BRYAN ALEXANDER FLORES-GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 RADIO HILL RD
MARION VA
24354-6587
US

IV. Provider business mailing address

175 LAUREN DR APT 5
ABINGDON VA
24210-4160
US

V. Phone/Fax

Practice location:
  • Phone: 276-944-6342
  • Fax:
Mailing address:
  • Phone: 951-565-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: