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General NPI Number Information
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NPI Number | 1205004694
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Entity Type | Organization
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Legal Business Name | ERNEST FLORES, MD, LLC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 119 MAIN ST SUITE 3
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City | ELKINS
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State | WV
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Zip | 26241-4111
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Country | US
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Telephone | 304-635-0110
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Fax | 304-635-0104
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Provider Business Mailing Address
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Address Line | 119 MAIN ST SUITE 3
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City | ELKINS
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State | WV
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Zip | 26241-4111
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Country | US
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Telephone | 304-635-0110
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Fax | 304-635-0104
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Authorized Official
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Title or Position | MD
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Name | DR. ERNEST FLORES
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Credential | MD
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Telephone | 304-635-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 15939
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License Number State | WV
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