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General NPI Number Information
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NPI Number | 1235990607
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Entity Type | Individual
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Provider Name | JUANA AZUCENA FLORES
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Gender | Female
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 2401 NW 23RD ST STE 2D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2420
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Country | US
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Telephone | 405-355-3239
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 SW 30TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-2311
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Country | US
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Telephone | 405-655-9054
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2579
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License Number State | OK
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