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General NPI Number Information
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NPI Number | 1205597374
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Entity Type | Individual
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Provider Name | YAUDIEL JESUS FLORES
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Gender | Male
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Dates
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Enumeration Date | 12/31/2021
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Last Update Date | 12/31/2021
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Provider Practice Location Address
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Address Line | 1533 OAKDALE RD STE B
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City | MODESTO
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State | CA
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Zip | 95355-3305
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Country | US
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Telephone | 209-324-8822
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Fax |
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Provider Business Mailing Address
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Address Line | 28007 TIFFANY LN
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City | ESCALON
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State | CA
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Zip | 95320-9802
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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 |
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License Number State |
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