MEDICARE: MS. ANGELA 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1407153380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA FLORES

Provider Business Mailing Address
First Line	:	7516 KNIGHT LAKE DR APT 154
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-6024
Country	:	US
Telephone Number	:	405-881-2233
Fax Number	:

Provider Business Practice Location Address
First Line	:	7516 KNIGHT LAKE DR APT 154
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-6024
Country	:	US
Telephone Number	:	405-881-2233
Fax Number	:

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

Provider Enumeration Date	:	02/11/2011
Last Update Date	:	12/15/2015

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