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General NPI Number Information
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NPI Number | 1558550269
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Entity Type | Organization
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Legal Business Name | FLORES MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 2902 HILLRISE DR
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City | LAS CRUCES
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State | NM
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Zip | 88011-4702
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Country | US
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Telephone | 505-522-5755
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Fax | 505-521-9385
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Provider Business Mailing Address
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Address Line | 2902 HILLRISE DR
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City | LAS CRUCES
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State | NM
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Zip | 88011-4702
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Country | US
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Telephone | 505-522-5755
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Fax | 505-521-9385
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A FLORES
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Credential | MD
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Telephone | 505-522-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20020142
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License Number State | NM
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