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NPI Code Detail

MEDICARE: MR. WILLIAM DOMINGO FLORES PA-C

MEDICARE:  MR. WILLIAM DOMINGO FLORES  PA-C
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
1363AM0700XMedical Physician AssistantPA9101746FL
2363AM0700XMedical Physician Assistant50.007917RXOH

Other Identifiers

General Provider Information

NPI Number : 1295754166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM DOMINGO FLORES PA-C
Provider Business Mailing Address
First Line : 1530 SAINT CLAIR AVE NE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2004
Country : US
Telephone Number : 216-535-9100
Fax Number : 216-298-5015
Provider Business Practice Location Address
First Line : 1530 SAINT CLAIR AVE NE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2004
Country : US
Telephone Number : 216-535-9100
Fax Number : 216-298-5015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 03/02/2023

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Directions to “ MR. WILLIAM DOMINGO FLORES PA-C” Practice Location

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