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General NPI Number Information
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NPI Number | 1184431058
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Entity Type | Individual
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Provider Name | JOSE R FLORES
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Gender | Male
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Dates
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Enumeration Date | 12/14/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 29826 HAUN RD STE 106
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City | MENIFEE
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State | CA
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Zip | 92586-6547
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Country | US
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Telephone | 951-723-1474
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Fax |
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Provider Business Mailing Address
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Address Line | 1022 S BRAMPTON AVE
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City | RIALTO
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State | CA
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Zip | 92376-7852
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 8943
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License Number State | CA
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