MEDICARE: EMILEE FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1194251363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILEE FLORES

Provider Business Mailing Address
First Line	:	1212 PIERRE DR SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-3527
Country	:	US
Telephone Number	:	505-315-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 PIERRE DR SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-3527
Country	:	US
Telephone Number	:	505-315-9066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2017
Last Update Date	:	05/10/2017

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Directions to “ EMILEE FLORES ” Practice Location

Language	Start Address	Practice Location

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