=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134893944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MINERVA ROBLES FLORES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2021
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5901 E 7TH ST # 122
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90822-5201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-625-2552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5901 E 7TH ST # 122
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90822-5201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-841-4146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 150.114043
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------