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General NPI Number Information
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NPI Number | 1003415472
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Entity Type | Individual
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Provider Name | RYANLEO FLORES NP
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Gender | Male
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 10/18/2020
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Provider Practice Location Address
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Address Line | 2017 1ST AVENUE SUITE 301
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City | SAN DIEGO
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State | CA
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Zip | 92101
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Country | US
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Telephone | 619-881-5035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 86465
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City | SAN DIEGO
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State | CA
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Zip | 92138-6465
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95013892
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License Number State | CA
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