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General NPI Number Information
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NPI Number | 1114511730
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Entity Type | Individual
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Provider Name | LUDIVINA FLORES NP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 1512 E GRIFFIN PKWY STE 2
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City | MISSION
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State | TX
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Zip | 78572-2422
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Country | US
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Telephone | 956-519-7088
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Fax | 956-519-9816
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Provider Business Mailing Address
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Address Line | 134 N SERAFIN ST
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City | ROMA
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State | TX
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Zip | 78584-8062
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP1006724
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License Number State | TX
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