Healthcare Provider Details

I. General information

NPI: 1124114624
Provider Name (Legal Business Name): MR. FRANK RO FLORES JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 SO 7TH
TACOMA WA
98405
US

IV. Provider business mailing address

3119 S 7TH
TACOMA WA
98405
US

V. Phone/Fax

Practice location:
  • Phone: 253-759-8390
  • Fax:
Mailing address:
  • Phone: 253-759-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: