MEDICARE: DR. ANGEL RAPHEL FLORES MD

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	207RC0000X	Cardiovascular Disease Physician	MD041891L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245236512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL RAPHEL FLORES MD

Provider Business Mailing Address
First Line	:	1034 GROVE ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2945
Country	:	US
Telephone Number	:	814-373-2310
Fax Number	:	814-373-2313

Provider Business Practice Location Address
First Line	:	765 LIBERTY ST
Second Line	:	105
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2566
Country	:	US
Telephone Number	:	814-373-2310
Fax Number	:	814-373-2313

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	02/03/2015

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